Types of paediatric alopecia
The most commonly spread paediatric (children) alopecia is non-scarring. They are tinea capitis, alopecia areata, traction alopecia, trichotillomania, telogen effluvium.
The particular case of alopecia is been diagnosed by visual investigation and in the case of scarring alopecia requires scalp biopsy.
It occurs very quickly overnight and it is alopecia areata where the immune system attacks the hair follicles in order to protect it from infection. 1 in 1000 children has alopecia areata plus ridging the nails that go hand in hand. Children till 5 years old do not really understand what is going on with them and find alopecia funny.
Tinea capitis (ringworm of the scalp)
Tinea capitis is the most commonly spread hair loss throughout the children all around the world. It is caused by a fungal infection of the scalp skin, eyelashes, eyebrows. It is also known as a superficial mycosis or dermatophytosis.
It's been diagnosed by looking at the scalp appearance: patchy hair loss, broken off hairs, black dots in the scalp, gray flakes. In order to examine the scalp precisely is used Wood's lamp where ultraviolet light is shined on the area of interest in a dark room. There's no need for a scalp biopsy to be performed to be diagnosed.
The most popular treatments are with griseofulvin taken orally for 2 months and with Nizoral shampoo for 2-3 times a week. The medical treatment should not be ceased at any time during this period. In most cases, tinea capitis is not contagious so children can visit and stay in public places.
Alopecia Areata happens accidentally and occurs in a specific manner as round patches over the scalp. The immune system attacks the follicles by mistake causing them to shrink and eventually disappear. Alopecia areata is not painful, it has got a psychological effect. The patches do not show any signs of inflammation. The reason why alopecia areas occur is still not discovered.
1 in 1000 children has alopecia areata plus ridging the nails that go hand in hand. Only 5% of them will develop alopecia Totalis (losing hair of the head) and just a few of them Alopecia Universalis ( losing hair of the body).
It is been diagnosed by visual examination and also an investigation of other reasons that could be a cause of alopecia, hidden infections, and inflammations. Patients usually go through a large variety of check-ups.
There is no official treatment of alopecia areata and the prescribed treatments are always off label. The treatment involves trying them all to see an effect. Sometimes alopecia recovers on it's within a year. But there are cases of remissions hence no life guarantee once disappeared.
Alopecia caused by trauma
The trauma alopecia is caused by external factors such as traction (wearing braids, pony-tails), friction ( rubbing against something permanently), chemical burns (any chemical interaction harmful to the scalp skin), trichotillomania (twirling or plucking the hair), trichology (eating the plucked hair). The two latter caused by mental disorder.
The hair recovers once the trauma is ceased.
Telogen Effluvium is a hair loss that has been caused by a severe and unexpected event of stress and the hair roots are forced prematurely into the resting phase. It could be acute and chronic. If the stress is severe more than 70% of the hair is being lost within months after the shocking event occurs. Hair appears thin initially and gradually gets lost.
In order to understand Telogen Effluvium one should know the hair growth process and stages:
Hair growth: The hair follicle has a long growth phase for 2 to 6 years (usually 3 years).
Transitional phase (3 weeks) when the hair degenerates
Resting phase (3 months) when the hair does nothing
Telogen phase: the hair growth process is restarted and the cycle repeats
In the telogen phase, something happens and hair starts falling. There is a large variety of reasons this could happen but some of them could be high fevers, surgery, excess vitamin A, emotional stress, severe injuries, certain prescription medication.
The hair recovers by itself after the shocking event passed, between six months and one year There's no particular treatment given. It is recommendable though to handle gently the hair. The diet involves a lot of protein, fruit, and vegetables.
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