Hair Loss and its Management in Children

Vibhu Mendiratta; Masarat Jabeen



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Expert Commentary

Diagnosing a given case of childhood alopecia is not just crucial for preventing irreversible hair loss, but may also turn out to be the necessary clue to an otherwise unfathomable multisystem illness or an explanation for an unexplained developmental delay. The most frequent causes of childhood alopecia (tinea capitis, alopecia areata, traction alopecia and trichotillomania) are usually reversible if detected early. The evaluation of a child with scalp hair loss should always include a detailed history, physical examination and microscopic examination of the hair. A thorough examination of scalp, skin, mucosa, teeth, nails and relevant systemic examination can be helpful in clinching accurate diagnosis. Newer techniques, such as videodermoscopy, trichoscan and contrast-enhanced phototrichogram aid in solving clinical dilemmas.

Congenital alopecia remains a largely neglected area with not many treatment options. There is a well perceived need for hair clinics dedicated solely to the study of disorders causing hair loss. Newer therapeutic armentatorium for alopecia areata, such as baxarotene, lasers (excimer, pulse infrared diode, fractional photothermolysis) and infrared irradiation has been found to be useful while biologicals and prostaglandin analogues (latanoprost, bimatoprost) has been found to be ineffective. N-acetylcysteine has been found useful in trichotillomania. Counseling and support groups can be invaluable to reduce psychological sequelae. Promising modalities for scarring alopecias are alginate gel implantation with microencapsulation of hair follicle stem cell and dermal papilla cells.


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