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Hair Loss In Children & Adolescents

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There are many congenital conditions that potentially affect normal hair growth, but it's thankfully infrequent for a child to be troubled with anything more than hair fall of a temporary kind. When problems do arise most can be treated successfully with simple alterations to the child's diet and/or hair care routine. The most common children's hair loss conditions that trichologists or other health professionals would see are outlined below.

"Loose anagen syndrome" is a temporary disorder of connective tissue competency where the hair can be painlessly pulled from the scalp with little effort. It presents as 'diffuse' (all over) hair loss, and is more commonly seen in fair-haired girls between the ages of 2 and 9 years.

"Fail to grow" scalp hair is thought to be a temporary delay in the growth response mechanism. Typically the child is female between the ages of 2 and 9 years, with fine hair of thin density. Presenting parents usually complain that the youngster has never had a haircut, because her hair has never grown beyond collar-length! The problem is frequently corrected with zinc and iron supplements at an appropriate dosage for the child's age. Increasing dietary protein intake would also assist regrowth.

Even without treatment intervention, both problems will usually recover by the time the child has reached puberty.

When poor dietary habits are extreme or have continued for a prolonged time, hair breakage, dull, dry hair, or even hair loss may eventually result. Teenage girls are most commonly 'at risk' here with "fad" dieting or inadequate consumption of iron-rich food sources. Simple advice on the value of the five food groups and commonsense eating habits is usually enough. A multi-vitamin/mineral supplement taken for 3-4 months can assist nutrition until a pattern of healthy eating is secured.

Alopecia areata may present in susceptible children of any age, and progress to the more severe forms where all body hair is lost. Alopecia areata is an inherited 'autoimmune' condition, which means the affected person's body is reacting against itself. This disorder is more often seen in dark-haired and Asian people, whilst 2-5% of children who develop alopecia are found to be gluten intolerant (the main protein of wheat).

Although anyone who develops alopecia has a genetic predisposition to do so, it's believed that some "trigger" initiates its presentation. This might be chronic emotional stress or severe shock, illness, vaccinations, or a chemical/foreign substance not previously exposed to. In adults, alopecia areata is closely linked to problems of the thyroid gland, vitiligo, and Sjogren's syndrome, whilst periodontal disease, chronic tonsillitis/sinusitis, or head injury are also thought to be precipitating factors.

Recently, Israeli researchers have revealed that the body's white blood cells may be reacting against the pigment cells within the hair shaft. That's why hair regrowth in alopecia areata is nearly always white i.e.; lacking any colour pigment.

Where alopecia develops in early childhood, it sometimes shows a tendency to become more intractable and less responsive to treatment. Severe alopecia areata can be very destructive psychologically, so investigations as to a possible cause, and treatment, should be undertaken without delay. At the same the treating practitioner should encourage an optimistic approach to the young patient's setback. Whilst treatments for alopecia areata are currently palliative and probably do not ultimately alter its course, complete hair regrowth can sometimes occur even in those with 100% scalp hair loss.

Traction alopecia is as the name implies, hair loss that occurs when the hair is held tightly under tension or "traction", causing the hair shaft to be eventually extracted from the follicle. Traction alopecia is regarded as mechanical hair loss, and is predominantly seen in females who continually pull their hair back in buns or ponytails. Here the problem presents as a 'thinning' of the hair behind the front hairline margins. This type of hair loss is also regularly seen with braiding or 'dreadlock' hairstyles. Provided the styling practice is identified and redressed early, the lost hair will recover.

Trichologists are now seeing increasing numbers young males and females with androgenetic alopecia (genetic 'patterned' hair loss). Developing this inherited complaint can be quite devastating for the adolescent in terms of their self-confidence, and the youth's parents who often express feelings of guilt for their child's affliction.

It cannot be overstated how important it is to refer these young clients and their parents to a qualified trichologist or family doctor, who can provide them with accurate information on the availability of effective approved medication. By doing this, these families are less vulnerable to the "slick" advertising promises of commercial hair loss centres that currently ask many thousands of dollars "up-front" for very dubious treatment programmes.

Four or five decades ago female androgenetic alopecia was mostly limited to elderly women. It's now not uncommon to see girls as young as 14-16 years presenting with this complaint. Female androgenetic alopecia begins as a progressive thinning-out of the top, temple and/or crown areas of the scalp. Occipital hair density is usually unaffected unless there is an underlying nutritional or metabolic disturbance. Unlike men's genetic hair loss, not all the hair follicles across the top of a woman's scalp are affected - thus 'thinning' of the hair density occurs rather than total baldness. Characteristic signs and symptoms should reveal the nature of the problem, but scalp biopsy still remains the definitive diagnosis.

Finally, "trichotillomania" is a somewhat uncommon condition where the child plucks his or her own hair from the scalp. It's often an unconscious act whilst concentrating or 'day-dreaming'. Sometimes though it's the result of underlying anxiety in the child from a stressful home, school, or other social situation. Affected areas have a ragged, uneven appearance where much hair breakage or empty hair follicles are evident. The crown area, behind the ears, or the opposite side of the scalp to the dominant hand is usually the area that's most ravaged. As with many habits, trichotillomania can be a difficult mannerism to arrest. Where the problem has existed for a number of years, psychotherapy, hypnosis, and/or antidepressant drugs are often used as treatments.

About the Author: Tony Pearce RN is a consulting trichologist and a registered nurse. He is a past chairperson for the International Association of Trichologists. He has published numerous articles on trichology issues and provides a website and online consultation service for people seeking accurate information, diagnosis and treatment.

Other areas of hairloss in this section you may be interested in:

Inherited Male "Pattern" baldness

What Men need to know about hair and hair loss

Female genetic thinning

Poor Diet Leads to thinning Hair

Lotions and potions

Treatments for baldness: Prescriptions and pharmaceuticals

Hair replacement: Transplant and single hair micrographs

Non-surgical hair replacement: Wigs and hairpieces

Menopause and hair loss

All other causes of hair loss

Hair loss in Pregnancy

Prescription medication and its links to hair loss

Alopecia defined

Laser treatment for hair loss

Hair Loss in Children and Adolescents

The Trichologist - your hair loss specialist, find out more


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