Tinea capitis, or ringworm of the scalp, is a fungal infection. Ringworm is a common cause of hair loss in children. It presents with scaly patches of hair loss on the scalp. The patches are generally round or oval. Scalp ringworm signs and symptoms can be more subtle though, with no scaling or itching, and broken hairs instead of hair loss (black dot tinea capitis).
Ringworm is contagious. Make sure your child does not share any objects that touch the head or scalp, such as towels, caps, scarf, pillow cases, or brushes.
Alopecia areata is thought to be an autoimmune disorder (the child’s immune system attacks the hair follicles) that causes complete hair loss in round or oval patches on a child’s scalp or other body parts. Unlike ringworm, the scalp involved in the round patches of alopecia areata is completely smooth, without redness or scale.
The patches are glossy or smooth there may be no scaling or broken hair. It is reported that nearly 25 percent of children with patchy hair loss may also have pitting and ridging of their fingernails. Most children regain lost hair within a year’s time, albeit re-growth is erratic, or one may lose hair again.
About 5 percent of children with the disorder may progress to alopecia totalis, or complete loss of all hair on the scalp. Some may also develop alopecia Universalis or a total of body hair.
This type of hair loss is caused when the child pulls, plucks, twists, or rubs his or her hair vigorously owing to emotional distress, peer and parental pressure. The hair loss is patchy and ‘represented’ by broken hair of varying lengths. Patches are also most often seen on the side of the child’s dominant hand. Girls, having emotional problems, seem more inclined to pull their own hair, rather than boys.
Trichotillomania is sometimes related to obsessive-compulsive disorder and is defined as a child or teen who compulsively pulls out her hair, feels tension before pulling or when trying to resist pulling, and feels pleasure, gratification, or relief when pulling her hair out. These children have noticeable hair loss and often need treatment from a child psychiatrist and/or child psychologist.
In addition to ringworm, hair pulling, traction alopecia, and the other causes of hair loss mentioned above, other less common causes of hair loss can include:
– thyroid disorders, including either hypothyroidism and hyperthyroidism.
– illnesses, such as systemic lupus erythematosus, diabetes mellitus, or iron-deficiency anemia.
– vitamin A toxicity.
– structural abnormalities of the hair shaft usually result in easy breakage and dry, brittle hair.
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