A modest amount of hair on your child’s brush or bathtub floor is nothing to worry about. We all shed about 50 to 100 hairs per day, according to experts with the American Academy of Dermatology.
At any given time, they say, about 90 percent of the hair on our heads is growing in a cycle that lasts anywhere from two to six years. The other 10 percent is in a resting phase that lasts just a few months, and ends with perfectly harmless shedding. As hairs shed, new hairs arise from follicles to replace them.
Excessive hair loss in children isn’t common but it can occur, according to Scottsdale dermatologist Amanda Carroll Rainwater, MD of Southwest Skin Specialists. Any worrisome changes in your child’s scalp or hair merits a trip to the pediatrician’s office. Often a simple visual exam will yield important clues to what’s going on.
There are plenty of possible culprits when alopecia, or hair loss, occurs in children, says Rainwater. Your child’s doctor will consider several factors, including:
- the pattern and amount of hair loss
- the type and degree of any hair breakage
- Â signs of scalp inflammation, such as redness or itching
The doctor also may explore your child’s overall health and wellness because certain types of illness or stress can impact hair growth. Rainwater recalls the case of a young teen whose excessive shedding when she showered or brushed her hair stemmed from nothing more insidious than a role in the upcoming school play.
Sometimes nutrition plays a role. A child who doesn’t eat a well-balanced diet may not get the vitamins and minerals necessary for healthy hair growth. Too little iron or protein in the diet can lead to hair loss.
Remind the doctor about any medications your child is taking, since some include hair loss among their side effects.
Share hair care factors that may be impacting your child’s hair health — such as excessive hair brushing, use of harsh chemicals or hair appliances or routinely wearing hair tightly braided or pulled back off the face. These can cause a condition called “traction alopecia,” which usually resolves over time, unless repeated trauma to the hair causes permanent scarring.
The pediatrician will likely use a special light or skin culture to check for ringworm, a fungal infection that can lead to hair loss, a scaly scalp and swollen lymph glands. Despite the name, worms have nothing to do with this one.
If no obvious cause is identified, your child may be referred to a dermatologist, a doctor who specializes in diseases of the skin. In some cases, Rainwater says, careful inspection of the hair and scalp will readily confirm a diagnosis. Sometimes additional tests are needed, including:
- Blood tests to check for nutritional deficiencies, hormonal factors or underlying illness such as thyroid disease, which can lead to hair loss.
- Hair-pull test. A simple tug on several strands of hair allows doctors to check the percentage of hairs that come loose. Loose hairs can provide clues to hair density and hair diameter.
- Punch biopsy. A small piece of scalp is removed and sent for lab analysis. Biopsies show the size and shape of hair follicles and reveal signs of inflammation, scarring or infection in the skin or around the follicles.
In some cases, hair loss results from trichotillomania, an “impulse” or “compulsive” disorder in which a child pulls out his/her own scalp hair and/or hair from other areas such as the eyebrows and eyelashes. Trichotillomania can lead to overall thinning and/or noticeable patches of missing hair. A dermatologist who has ruled out other factors and suspects this disorder may refer your child to a psychiatrist for further evaluation.
Whatever the cause of your child’s hair loss, be accepting and supportive, urges Jana Davis, a Paradise Valley mom whose own battle with alopecia began at the tender age of 7. Acknowledge your child’s feelings, but lose the shame factor.
“If you’re comfortable with it, others will be too,” she says.
Once a diagnosis is established, your child’s doctor can determine which treatment options are most appropriate — from simple changes in hair care or diet to topical solutions or oral medications.
When a child’s hair loss is severe, the doctor may suggest a hair prosthesis. Locks of Love is a Florida-based non-profit that provides hair pieces to financially disadvantaged children with long-term medical hair loss. To learn more about receiving or making a hair donation, contact them toll-free at 888-896-1588 or locksoflove.org.
