Nicole Rogers: There are several reasons why children can loose their hair. Up to two million children in the United States are affected by hair loss. The good news is that we do have treatments, but it's unpredictable how well they will respond to the treatments.
In some cases, the hair regrows completely on its own without any treatment whatsoever. Assessing the type of hair loss can be tricky. If the hair loss is very diffused, the first question we try to understand is how long they have been having this hair loss and if they have had any major physiologic stressors that could possibly explain a short term shedding process such as a prolonged hospitalization, a high fever. If they were to suffer low iron stores, that could be a dietary or nutritional aspect, certain medications such as isotretinoin can also cause short term hair shedding. Everyday stress in and of itself is not usually a cause of hair loss. Now if the child is suffering from severe physiologic stress such as due to bullying or dealing with a divorce or loss of a loved parent or sibling then, certainly that very well may be a factor. Probably the most common is Alopecia Areata which is the appearance around or oval shaped shiny patches of hair loss and there is usually not any symptoms associated with this, but it can be very troublesome to children and to their caregivers because it is noticeable to others and it can also to hard to camouflage. There is a particular form of hair loss we see in African American patients, due to pulling or twisting of the hair and this is something we call Traction Alopecia and it can be avoiding by not using tight ponytail holders or tight braids, braids can be offenders and typically people can develop hair loss right across the sideburn area or even across their entire hairline. One uncommon form of hair loss that we see in children is called Trichotillomania. And this is an actual inherited obsessive compulsive disorder, where children will repeatedly pull or break at their hairs and it can be hard to eliminate without behavioral modification or possibly psychiatric intervention.
Now one thing is to understand is just because your child is only 13 or 14 it's not impossible that they may have developed or inherited a form of Androgenetic Alopecia from another family member and we actually do see female and male pattern thinning in children as early as 14 or 15.
For children under the age of 18 who are developing an early case of either male or female pattern thinning I usually recommend starting with topical row gain or minoxidil and this is a topical medicine which will help increase the thickness of the hair and also increase the amount of time that they are in the actively growing phase.
For kids especially those who suffer from an oily scalp the use of a daily dandruff shampoo such as either ketoconazole or zinc pyrithione can make a big difference in their overall scalp hygiene. It's important as a parent that you prepare your children for the changes in their bodies including hair growth in places they didn't expect such as under the arms. But sometimes young women can develop hair growth in places like their face. And if this is present along with things like irregular periods or very severe acne or hair thinning on the top of the scalp that may indicate that they are suffering from a condition called polycystic ovarian syndrome.
And this is something that can be diagnosed by the obstetrician or the gynecologists. If your child has being suffering from hair thinning or hair loss for a period greater than six months, I would definitely seek the advice of a local dermatologist or a local physician who specializes in hair disorders.