A Practical Approach to the Diagnosis and Management of Hair Loss in Children and Adolescents

Abstract

Hair loss or alopecia is a common and distressing clinical complaint in the primary care setting and can arise from heterogeneous etiologies. In the pediatric population, hair loss often presents with patterns that are different from that of their adult counterparts. Given the psychosocial complications that may arise from pediatric alopecia, prompt diagnosis and management is particularly important. Common causes of alopecia in children and adolescents include alopecia areata, tinea capitis, androgenetic alopecia, traction alopecia, trichotillomania, hair cycle disturbances, and congenital alopecia conditions. Diagnostic tools for hair loss in children include a detailed history, physical examination with a focused evaluation of the child's hair and scalp, fungal screens, hair pull and tug test, and if possible, light microscopy and/or trichoscopy. Management of alopecia requires a holistic approach including psychosocial support because treatments are only available for some hair loss conditions, and even the available treatments are not always effective. This review outlines the clinical presentations, presents a diagnostic algorithm, and discusses management of these various hair loss disorders.

Atrichia with papular lesions: A case report

“…[2][3][4][6][7][8][9][10][11][12][13][14][15][16][17] It is suspected to be more common than current estimates, as APL is often mistaken for autoimmune AU, achieving the diagnosis after patients fail to respond to standard treatment modalities. 2,18 In APL, hairs are typically absent from the scalp, axillae, and body, and individuals are almost completely devoid of eyebrows and eyelashes. 11 Lanugo hairs are present at birth, but alopecia is complete within the first year of life as catagen follicles are unable to re-enter the anagen phase.…”

Trichotillomania and Trichophagia: Modern Diagnostic and Therapeutic Methods

“…Furthermore, hair loss resulting from different underlying causes may have similar clinical manifestation. Common causes of alopecia in children and adolescents include alopecia areata, congenital alopecia, traction alopecia, tinea capitis, hair cycle disturbances, and TTM [ 3 , 4 ]. Alopecia may also be a consequence of endocrine disorders, systemic illnesses, unbalanced diet, trauma, infections, genetic predispositions, or drugs [ 5 ].…”

Kerion Celsi: A Tinea Capitis Rare Complication

“…Como indicaciones adicionales, se indica llevar una buena higiene personal evitando el uso de objetos personales, además de que todos los miembros de la familia deberán de ser examinados para tratamiendo preventivo con shampú de sulfato de selenio, o de ketoconazol al 2% por un par de meses 3,10 .…”

“…A pesar de la evidencia, aún no hay consenso entre la restricción de actividades sociales, recomendando algunos estudios el ausentismo escolar hasta 5 días luego de la terapia oral 2 . Además, es importante aconsejarle al paciente regresar a sus controles y llevar una buena higuiene, evitando el compartir objetos personales, todo esto aunado a la examinación de todos los miembros de la familia y recomendar como tratamiento de contactos cercanos el uso de Shampús de Sulfato de selenio o de ketoconazole 2% por un par de meses para su erradicación 10 .…”