Alopecia means hair loss and alopecia in children can be caused by a variety of conditions. For most children, doctors can identify one of the following issues:
To diagnose the cause of alopecia, your child’s doctor will examine his or her scalp for visible symptoms. Tinea capitis is usually diagnosed by microscopic examination. Alopecia areata is diagnosed through a physical examination and medical history. Trichotillomania is often diagnosed by ruling out other conditions, a physical examination, and a conversation about recent stressors. A trichogram and hair-pull test may be used for telogen effluvium, and your child’s doctor will follow up to ensure hair growth returns after the stressful event. Nutritional deficiencies and hypothyroidism, if suspected, can be diagnosed through blood tests.
There are a number of alopecia treatments, depending upon the type of condition for which your child has been diagnosed. If your child’s doctor diagnoses tinea capitis, he or she will prescribe an oral antifungal medication and an antifungal shampoo. Your child should not share any hats, pillowcases, or other items that touch the head, because this infection is contagious.
For alopecia areata, there is no cure, but treatment can often control the disorder. If your child is young, his or her doctor may prescribe strong corticosteroid ointments you can apply to bald spots. Other options include intralesional treatment, oral treatment, and topical immunotherapy.
Counseling can help children manage stress that leads to trichotillomania, so your child’s doctor may refer you to an appropriate professional. Telogen effluvium has no treatment, so your child’s doctor will follow up to ensure hair growth is restored. Nutritional deficiencies – if identified – can be treated with supplements, but speak to your child’s doctor first.
And, if your child is diagnosed with hypothyroidism, a referral to an endocrinologist may be indicated.
The most common causes are non-medical (pulling hair too tight, brushing roughly, newborn hair loss) or caused by tinea capitis (a fungal infection), alopecia areata (immune system attacking hair follicles), trichotillomania (hair pulling or plucking often caused by anxiety), or telogen effluvium (caused by severe illness or other stressful event).
Most cases are diagnosed based on physical examination and medical history.
Though loss of hair can be scary and lead to low self-esteem, with proper diagnosis, many cases of hair loss can be treated successfully.
Though most causes of hair loss are not physically painful or life threatening, living with hair loss can be socially and emotionally challenging – especially for children and teens. You can help your child cope by learning as much as you can about his or her condition, pursuing treatments under a doctor’s care, and joining recommended support groups or seeking counseling that can help your child build a positive self-image.