Children Hair Loss

Children’s Tinea Capitis

Tinea Capitis is an illness caused by fungal infection of the skin of the scalp, eyebrows and eyelashes, with a tendency for attacking hair shafts and follicles. It is also called “ringworm of the scalp“. The condition is caused by a fungus that occupies the hair shaft and causes the hairs to break. The naked patch of hair loss is often round and the scalp takes on a black-dotted stubble appearing from hair shafts broken off at the surface. There may also be moderate itching and scaling. The condition is transmitted by contact from one infected child to another through the sharing of combs, brushes, hats, barrettes, pillows and bath towels. Minor bruising of the scalp sometimes provides an entry for the microscopic fungus. Children  10 years of age are more susceptible and boys are more so than girls. Ringworm of the scalp is not threatening. Without treatment, however, the hair fall can be extensive, and some children will develop a boggy, tender swelling of the scalp known as a kerion.

Children’s Alopecia Areata

Alopecia areata is another common form of patchy hair loss in children. The typical story is the sudden appearance of one or more totally bald areas in the scalp. The child with this condition loses hair in circular patches sometimes up to two inches in diameter. The hair at the lines of these patches is loose, but the peach-colored scalp looks and feels normal, without scaling or inflammation. There may be just a few patches of hair loss or a total absence of body hair. Alopecia Areata is not so dangerous, and children who have it are otherwise healthy. Why the hair shadings out from the roots is still a mystery. What is known is that the condition is not contagious, caused by foods, or the result of nervousness, hyperactive disorders, or psychological stress. In 20% of cases, another family member has been affected. Some patients with this condition will also develop a grid-like pitting of the nails. Fortunately, over 80% children with alopecia areata grow new hair within 12 months. Strangely, the new hair can temporarily be white, but eventually the hair returns to its natural color. This is a much higher resolution rate than is seen in adults with the same condition, so the news is satisfaying.

Children’s Traction Alopecia

Traction Alopecia, or physical damage to the hair, is another common cause of hair loss, particularly in girls. The human hair is quite fragile and does not respond well to the many physical and chemical invasions it has to brave in the name of beauty. Constant teasing, fluffing, combing, washing, curling, blow drying, hot combing, straightening and bleaching can do a number on the fragile hairs, causing them to fall out, especially around the hairline and along the front and sides. In adults, this is not as constant a problem, as the hair has grown in strength and quality over several years, but it can act a problem for our little companions who typically have much thinner, fairer and less dense hair. Styles that apply tension to the hair, such as tight ponytails, braiding, barrettes and permanent waving can also damage the hair. However, one should not estimate that hair loss in one’s child is due to pony tails that are too tight. If hair loss is noted, it is imperative that a physician evaluate the child and rule out other causes. Recommended treatment for children’s traction alopecia is to handle the hair gently, as little as possible, and use natural hair styles. The hair will usually return, but regrowth can be slow. Injured hair follicles do not heal quickly and often take 3 or more months before they are back to their growing phase.

Hair Loss: Infectious Agents 1

Some of the infectious agents and infection-related conditions can cause to hair loss. I want to explain some common ones.

1) Ringworm

Surprisingly, ringworm has nothing to do with worms, but is a fungal infection that can found anywhere on the body. If it develops on the scalp, it can cause patches of hair loss and is known to doctors as “tinea capitis.” Ringworm is the same thing as athlete’s foot, and the same kind of fungal infection that can affect the nails too.

On the scalp, ringworm usually starts as a small pimple that progressively expands in size, leaving scaly patches of temporary baldness. The fungus gets into the hair follicles in the affected area and these hairs become brittle and break off easily, leaving a bald patch of skin. Affected areas are often itchy, red, and inflamed, with scaly patches that may bubble and ooze. The patches are usually redder around the outside with a more normal skin tone in the center. This may create the appearance of a ring — hence the name, ringworm.

Worldwide, the fungus Microsporum audouinii is a very common cause of ringworm, but increasingly Trichophyton tonsurans can also cause tinea capitis, especially in the US and Latin American countries. Other fungi that may cause tinea capitis include Trichophyton schoenleinii andTrichophyton megninii in Southern Europe and Africa, and Trichophyton violaceum in the Middle East.

The fungus Microsporum gypseum can also sometimes cause tinea capitis. This fungus is common in soil and may be transferred to humans by contact with infected animals. You can also get ringworm from pets that carry the fungus, and cats in particular are common carriers. Ringworm is contagious. It can be passed from one person to the next by direct skin-to-skin contact. You can also catch ringworm through contact with contaminated items such as combs, unwashed clothing, and shower or pool surfaces.

Treatment for ringworm varies depending on the particular fungus involved. Some types of ringworm infection will go away spontaneously and no treatment is given. You should choose some natural treatment.

2) Folliculitis

Folliculitis is a term for inflammation of hair follicles. It looks like acne with little rings of inflammation surrounding the opening of a hair follicle. In the early stages of a folliculitis, the hair fiber may still be present, but as the folliculitis progresses the hair often falls out. When folliculitis is severe, inflammation is so intense that it can permanently destroy the hair follicles, leaving little bald patches.

There are non-infectious forms of folliculitis, such as those caused by oils and greases applied to the skin that clog up the hair follicles, but folliculitis is usually due to a bacterial infection. Particularly common is an infection of the hair follicles by Staphylococcus aureus. “Hot tub folliculitis” is caused by Pseudomonas aeruginosa which grows in inadequately chlorinated water

Hair Structure and Life Cycle

 Hair is composed of strong structural protein called keratin which is the same kind of protein that makes up the nails and the outer layer of skin.

Each strand of hair consists of three layers.An innermost layer or medulla which is only present in large thick hairs.The middle layer is known as the cortex. The cortex provides strength and both the color and the texture of hair. The outermost layer is known as the cuticle. The cuticle is thin and colorless and serves as a protector of the cortex. Structure of the hair root.Below the surface of the skin is the hair root, which is enclosed within a hair follicle. At the base of the hair follicle is the dermal papilla. The dermal papilla is feed by the bloodstream which carries nourishment to produce new hair. The dermal papilla is a structure very important to hairgrowth because it contains receptors for male hormones and androgens. Androgens regulate hairgrowth and in scalp hair. Androgens may cause the hair follicle to get progressively smaller and the hairs to become finer in individuals who are genetically minded to this type of hair loss.

The Hair Growth Cycle

Hair follicles grow in repeated cycles. One cycle can be broken down into three phases.

Anagen – Growth Phase
Catagen – Transitional phase
Telogen – Resting Phase
Each hair passes through the phases independent of the neighboring hairs.

Anagen Phase – Growth Phase

     Approximately 85% of all hairs are in the growing phase at any one time. The Anagen phase or growth phase can vary from two to six years. Hair grows approximately 10cm per year and any individual hair is unlikely to grow more than one meter long.

Catagen Phase – transitional phase

     At the end of the Anagen phase the hairs enters into a Catagen phase which lasts about one or two weeks, during the Catagen phase the hair follicle shrinks to about 1/6 of the normal length. The lower part is destroyed and the dermal papilla breaks away to rest below.

Telogen Phase – resting phase

     The resting phase follows the catagen phase and normally lasts about 5-6 weeks. During this time the hair does not grow but stays attached to the follicle while the dermal papilla stays in a resting phase below. Approximately 10-15 percent of all hairs are in this phase at an one time.

At the end of the Telogen phase the hair follicle re-enters the Anagen phase. The dermal papilla and the base of the follicle join together again and a new hair begins to form. If the old hair has not already been shed the new hair pushes the old one out and the growth cycle starts all over again.