Contents
Alopecia in children – this is a thinning or absolute loss of hair on the head of a child with a violation of further hair growth. Often their loss occurs in parallel with the loss of eyelashes and eyebrows. The area of alopecia varies, around its foci, the hair shafts become significantly thinner and break. To determine the true cause of alopecia in childhood, you need to visit a trichologist.
According to statistics, alopecia in children is not as common as baldness in adults. The disease affects no more than 3% of children. However, this is not a reason for the loss of relevance of this pathology in pediatrics and dermatology. Most often, alopecia in a child is characterized by high intensity, and with timely and competent treatment, it can be successfully corrected.
Causes of alopecia in children
Hair loss in childhood occurs under the influence of certain factors that affect the normal functioning of the hair follicles.
Among the possible causes of alopecia in children:
hereditary predisposition. There is evidence that children who have suffered from alopecia from an early age are also prone to this pathology. Therefore, familial forms of alopecia cannot be excluded;
Violation of the ratio of macronutrients in the body. Most often, this problem occurs against the background of various diseases of the digestive system. Therefore, one of the following diseases can become a provocateur of alopecia in a child: malabsorption, parasite infection, gastroduodenitis, reflux disease, dysbacteriosis, chronic constipation, etc. Hair loss becomes more intense if the child’s body suffers from a lack of chromium, molybdenum, copper, and zinc, selenium, as well as folic acid and cyanocobalamin;
Violations of the functioning of the immune system. So, pathology often develops against the background of existing autoimmune diseases, for example, vitiligo or atopic dermatitis;
Neuroendocrine pathologies, including thyroid diseases, in particular, hypothyroidism. The transferred mental traumas, neurosises affect;
Diseases of an infectious nature, such as erysipelas, chicken pox, pneumonia, influenza and others;
Injury to the scalp as a result of a burn (chemical or thermal). The tension of the hair shaft negatively affects the condition of the hair, which can be observed when weaving braids or tying tails is too tight;
Trichotillomania or self-pulling of hairline due to mental illness or due to stress. At the same time, the child constantly twists and pulls out his strands;
Hematological syndrome with a decrease in the level of hemoglobin and red blood cells in the blood (anemia);
exposure to x-rays;
Often parents pay attention to the fact that the hair in the area of the crown and neck falls out in newborns and infants. As a result, bald patches form on the head. Previously, the cause of such alopecia was considered to be that the child simply erases the hair on the back of the head. However, studies indicate that hair falls out in those children who sleep on their stomachs. Therefore, doctors are inclined to believe that with normal health and physical development of the child, such a loss is a physiological feature;
Surgical intervention with the use of anesthesia;
Both the lack of vitamins and their overabundance can negatively affect the condition of the hair. In particular, excessive blood levels of vitamin A are dangerous. Hair also falls out when taking certain medications;
Fungal infection of the scalp. More often than others, baldness in children develops as a result of a disease such as ringworm;
Chronic telogen alopecia. Doctors call this cause of hair loss if all other options are excluded. In chronic telogen effluvium, the hair is at rest and does not grow after the natural death of the previous hair shaft.
Classification of alopecia in children
There are the following types of alopecia diagnosed in childhood:
Alopecia is congenital. This pathology is quite rare. As a rule, it does not occur as a single problem, but is accompanied by other diseases of the endocrine sphere, skin, congenital epidermolysis, etc. Alopecia develops due to the fact that a certain part of the follicles from which hair should grow is simply absent. As a result, some areas of the head remain hairless;
Physiological baldness. This type of alopecia is observed in children of the first year of life. Hair falls out at the back of the head, in the forehead. This process does not require treatment, since the natural growth of hair shafts resumes on its own;
Alopecia areata or alopecia areata. On the head of a child with this type of disease, lesions are formed that have a rounded shape. The causes of such hair loss most often lie in the autoimmune processes that occur in the child’s body. The prevalence of pathology is 1 in 1000;
seborrheic alopecia. This type of baldness is formed against the background of already existing seborrhea, while the hair falls out during the puberty of the child;
atrophic alopecia. With this type of baldness, hair falls out on the crown and forehead. This condition is also called “Brock’s pseudopelade”, most often the pathology affects women over the age of 35, however, cases of the disease in childhood are described in medicine.
Symptoms of alopecia in children
Symptoms of alopecia in children will vary depending on what type of baldness the child has:
With alopecia areata, which most often develops in children after 3 years, the baldness zones have a rounded shape. The focus can be one or more, their boundaries are clear, the size varies (from small areas to bald patches the size of a palm). In parallel, eyebrows may fall out, but the back of the head and the crown of the head are predominantly affected. The skin of the child does not itch, does not peel off. Often against the background of alopecia areata in children, vitiligo and dermatitis are often diagnosed. Nails can break, hollows form on them and their color changes;
Atrophic type of alopecia characterized by the appearance of baldness zones in the form of flames. The skin in these areas is smooth and shiny, not flaky or inflamed. The follicular orifices themselves are not dilated. Restoration of hairline in those areas where it was lost during atrophying alopecia is impossible;
Alopecia seborrheic characterized by increased oiliness of the hair, crusts and scales appear in the basal region. The skin is very itchy, the child begins to comb his head, injuring the skin. As the disease progresses, the hair begins to fall out with the formation of areas of baldness in the future. Complete loss of cover is observed at the crown.
Diagnosis of alopecia in children
When a child has hair loss, this process cannot be ignored. In addition to the pediatrician, doctors of other specialties should be involved in the diagnosis: trichologist, dermatologist, endocrinologist, gastroenterologist, neurologist. Each of the doctors, if necessary, will make a plan for an individual examination of the child.
The trichologist, in turn, must perform:
Trichogram (examination of hair roots under a microscope);
Phototrichogram (performing trichographic images of a scalp area and processing the data obtained using a computer);
Diagnosis of the scalp using a complex system (microcamera and computer program);
If you suspect lichen planus or lupus erythematosus, they resort to a biopsy of the scalp and further histological examination of the material obtained.
To exclude possible circulatory disorders, the child may be referred for rheoencephalography. Spectral diagnostics of hair and blood sampling for microelements can give information about the microelement status of a child.
Treatment of alopecia in children
Therapy of the disease is determined only by the doctor based on the diagnosis. Drawing up an effective treatment regimen is possible only after finding out the true causes of hair loss. For successful restoration of the hairline, regular monitoring by specialists will be required.
However, regardless of the etiology of the disease, the child is shown restorative therapy:
Immunomodulators, for example, Viferon, Kipferon, Cycloferon, Anaferon, Immunal;
Vitamin therapy with a predominance of B vitamins (B1, B12, B6), vitamins A, E and C;
Fitin and pantothenic acid, methionine;
Hormonal drugs (prescribed when total baldness is detected). Among the drugs that are prescribed in childhood more often than others: Advantan, Lokoid, Elokom, and Afloderm;
With Broca’s pseudopelade, the application of prednisolone ointment is recommended.
If other diseases that led to the development of alopecia were identified, their therapy is carried out. For example, anemia is eliminated by taking iron preparations, viral diseases are treated with antiviral agents, fungal skin lesions are eliminated by the use of antimycotic drugs.
In addition, the child may be prescribed treatment with the use of ultraviolet irradiation with preliminary smearing of the lesions with Ammifurin or Beroxan – creams that have photosensitizing properties.
To get rid of seborrheic alopecia, darsonvalization can be prescribed. This method is based on the impact on the scalp with Darsonval currents.
Hair transplantation can be prescribed when hair loss is caused by cicatricial alopecia, previous trauma, chemical or thermal burns. Transplantation is resorted to only when conservative treatment is ineffective.
Treatment of alopecia with such a popular remedy as Minoxidil is unacceptable in children, as this threatens to develop side effects.
Sometimes children suffering from alopecia may need consultation and supervision of a psychologist. Often, baldness creates a feeling of self-doubt, the child’s self-esteem decreases, and problems appear in communicating with peers.
As for the forecast, in some cases it can be quite problematic to give it. The fact is that often children’s baldness goes away without any therapy. The prognosis is worse if alopecia is total, it affects the child at an early age. It is important to determine the cause that led to the problem, because if it is not eliminated, alopecia will recur.
Prevention of alopecia in children
Preventive measures include:
It is necessary to treat all diseases in a timely manner. The transition of any disease into a chronic form threatens hair loss;
The organization of good nutrition is important;
The child must adhere to the daily routine, one should not overload him too much with both physical and mental labor. Good rest is the most important condition for the prevention of alopecia;
If the child’s hair is thin, then the traumatic effect on them should be minimized. For this, boys should be cut often and short, and girls are forbidden to tighten braids and tails tightly;
Reducing the frequency of shampooing is also a prevention of alopecia. Children with weak hair should not wash their hair more than twice a week.
Physiological baldness in early childhood does not require any specific preventive measures, as well as specialized treatment. The hairline in this case is restored on its own.
Author of the article: Herman Olga Leonidovna, trichologist, specially for the site ayzdorov.ru