Seeing your child loosing hair is nothing short of a nightmare for the parents, especially in case of total and irreversible hair loss.
Hair loss in children can be attributed to various common and uncommon causes. Correct diagnosis is an important factor in identifying the right cause and in preventing hair loss. An early management is also needed to deter the psychological effects of hair loss on the mental and physical growth of children.
It is one of the commonest causes of hair loss. According to a study, Tinea Capitis (ringworm of the scalp) accounts for 40% cases of hair loss in children. Usually characterized by redness of scalp, hair loss and by a scaly border that may be itchy, signs and symptoms can sometimes be subtle. The patient may sometimes have broken hairs instead of hair loss (black dot Tinea Capitis) without scaling or itching. An infective condition, Tinea capitis responds readily to right medical therapy.
It is found to be the second most common cause of hair loss in children with a prevalence of 26.2%. Considered usually in the differential diagnosis of Tinea Capitis, it can be diagnosed by a simple scalp examination.
The third major cause of hair loss in children, telogen effluvium accounts for 17.6% of the cases reported. While it is commonly associated with a preceding history of fever, telogen effluvium generally results from a traumatic stimulus causing diffuse hair loss without clear areas. Broken-off hair or exclamation-point hair is absent in this condition. Anaemic children are also found to be suffering from telogen effluvium.
Other known causes
While these three conditions are found to be mainly responsible for hair loss in children, some other causes may be:
Topical application of potent corticosteroids is found to be effective for treating moderate-to-severe alopecia areata in children.
Topical steroid is generally recommended as the first-line treatment for paediatric cases. Researchers suggest the use of topical corticosteroids such as 0.05% clobetasol propionate lotion, followed by the application of lower potency corticosteroids including 0.1% mometasone furoate or 0.1% betamethasone valerate scalp lotion.
Studies have found the use of Minoxidil (2, 4 dinitro-6-piperidinopyrimidine-3-oxide) to be an effective topical treatment for non-scarring alopecia.
Generally, experts recommend topical 2% or 5% minoxidil as an adjunctive treatment, to be applied in combination with topical or intralesional steroids. Minoxidil is a prescription drug. It is advised to use it after your dermatologist prescribes it, as topical minoxidil has been reported to aggravate pre-existing seborrhoeic or atopic dermatitis or cause irritant contact dermatitis
Though intralesional corticosteroids are usually not recommended to children due to the fear of injections and pain, topical anaesthetic creams including EMLA (eutectic mixture of local anaesthetics containing lidocaine 2.5% and prilocaine 2.5%) can be prescribed to alleviate pain and increase patient acceptance.
Topical immunotherapy is generally recommended in the case of chronic and extensive alopecia areata, especially where prolonged topical or intralesional corticosteroid injections are ineffective. Studies have found that about one-third of children experience re-growth after topical immunotherapy.
What we have here is some basic information on the major causes and available treatment options for hair loss in children. However, since symptoms and diagnosis may vary for individuals, it is advised not to self medicate and to report any kind of hair loss to a paediatric dermatologist as early diagnosis can go a long way in ensuring effective treatment.
 Hair Loss in Children: Common and Uncommon Causes; Clinical and Epidemiological Study in Jordan. 2015. Hair Loss in Children: Common and Uncommon Causes; Clinical and Epidemiological Study in Jordan. [ONLINE] Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999647/. [Accessed 30 December 2015]
 Current Treatment Strategies in Pediatric Alopecia Areata. 2015. Current Treatment Strategies in Pediatric Alopecia Areata. [ONLINE] Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3519253/. [Accessed 30 December 2015]