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Alopecia in Children

Prominent Causes of Alopecia in Children and Curative Treatments

The condition of hair loss is clinically known as alopecia. It is not only a common condition in adults, but it affects children too. This article outlines some of the common causes of alopecia in children and their treatment measures.
Debopriya Bose
Last Updated: Feb 21, 2018

Baldness, or hair loss can occur in many forms and affect people of all ages. Although not common in children, alopecia can be quite traumatic for both the affected child as well as the parents. However, the good news is, in most cases, it is curable. Almost 60% of the children with one or the other form of hair loss get their hair back; this may take a few months to over a year. For those who do not, various cosmetic remedies are available to camouflage the hairless spots.

What Causes Baldness in Children?
Fungal Infection
One of the most common causes of alopecia in children could be linked to a fungal infection that affects the scalp. It is called tinea capitis (ringworm of the scalp). Fortunately, once the infection resolves, hair starts growing back. Mostly common seen in toddlers and school-aged children, this highly contagious infection commonly causes the following symptoms:
  • Scaly, itchy bald patches on the head
  • Bald patches are mostly round and may seem to expand
  • The patches may be painful and become red and swollen
Autoimmune Problems
Alopecia areata, a type of baldness, is believed to be an autoimmune condition. Here, the immune system of the body damages the hair follicles, resulting in patchy baldness. This condition, however, does not cause permanent baldness; in most cases, hair starts growing back within a few months or a year. This type of baldness is more prevalent in people with chronic, autoimmune conditions like diabetes, thyroid disorders, and vitiligo to name a few. Symptoms that indicate this condition include:
  • Hair loss that starts occurring suddenly
  • Circular bald patches that may overlap
  • Pitted fingernails and toenails (in some people)
Traction Alopecia
One more common cause of alopecia in children is known as traction alopecia. Not an illness, traction alopecia occurs from injury caused to the hair roots, when they are being subjected to constant pulling force. People with tight braids and ponytails are more prone to experience this problem.
An idiopathic condition (no known cause), trichotillomania is an irresistible urge to pull one's hair from the head and other areas. This results in patchy bald areas. This condition is found more in children between the ages of 11 and 13, and men and women are equally affected by it. Symptoms that may accompany the constant pulling of hair include:
  • Chewing or playing with the pulled out hair
  • Exhibiting relief after having pulled out some hair
  • Eating hair, rubbing it across the face or playing with it
Telogen Effluvium
The normal growth hair cycle has three stages. This cycle starts with anagen -- the growth phase, catagen -- the short transition phase when the hair follicles degenerate, and ends in the telogen phase -- the resting phase. After the resting phase is over, new hair grows pushing out the older strands of hair. However, medical conditions, stress factors, or certain medicines may sometimes disrupt the normal hair growth cycle and cause hair follicles that were in the anagen phase to prematurely enter the telogen phase. Once the person recovers from the illness, the hair (follicles had earlier gone into a resting phase) are shed. This results in excessive hair loss, which is known as telogen effluvium. Fortunately, this is a type of temporary hair loss.
Anagen effluvium
Children or adults undergoing treatment, such as chemotherapy or other cancer treatments may experience hair fall. The hair that is lost is said to be in the anagen stage; thus this condition is known as anagen effluvium.
Treatment Offered
Treatment for alopecia depends upon the underlying cause of the condition.
If the underlying cause is tinea capitis, then oral antifungal treatment is required. Topical antifungal creams and shampoos containing 2% ketoconazole may also be recommended. These topical applications need to be used about 2 to 3 times every week. Although these treatments may decrease scaling, the infection may reappear.
In case of alopecia areata, which is incurable, various treatment measures are available. However, as in most cases, hair usually grows back within a year; so doctors ask patients to follow a wait-and-watch approach. It is important to note that this type of baldness is different for different people. In some people, hair growth may resume but they may experience hair loss again later, while in some, after hair starts growing, they stay. When the condition does get treated, it mainly comprises off-label medicines, such as corticosteroids; children with alopecia areata are usually treated with topical corticosteroids.
Hair loss due to telogen effluvium usually doesn't require any treatment. Once a child recovers from the condition that triggered hair loss, hair grows back into the areas from which they were shed.
If your child's hair loss is due to trichotillomania, then the treatment may mainly comprise psychotherapy. It basically helps the affected person to recognize their urge to pull hair and substitute it with other behavior. For instance, when there is an urge to pull hair, the person may clench their fist or redirect their hand somewhere else, rather than the hair. Sometimes, antidepressants may also be recommended to manage trichotillomania.
Traction alopecia can be reversed by avoiding hairstyles, like braiding, ponytails, and anything that may keep the hair tightly bound and in constant tension.
For people with anagen effluvium, it may take several weeks before their hair growth resumes. In most cases, when the hair starts growing back, it may have a different texture or color from what it used to be earlier. There are certain treatment methods in place which may help prevent hair loss during or after chemotherapy, but they do not guarantee satisfactory results.
Alopecia in children may also be genetic, which unfortunately does not have any cure. Some options for treating the condition may include arresting hair fall, or promoting hair growth.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical professional.
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