Assessing Hair Shedding in Children

Abstract

Background: The wash test is currently used to assess hair shedding, though it lacks a cut-off point of normality and any evidence of being reliable. The aim of this study is to provide data to fulfil those needs. Methods: The wash test was employed in a standardized way on 31 children aged 3–11 years. Results: The test yielded 10.68 ± 3.91 hairs, a figure which may be considered as ‘normal’ for children of that age. The χ² test granted the validity of the method. The number of shed hairs counted in the washing basin increased with the age of the subjects. Comment: The wash test proved to be reliable and to be a useful tool for monitoring hair shedding. The increasing trend with age may suggest a possible prepubertal onset of androgenetic alopecia.

Setting reference values in trichology

“…11 Secondly, girls shed significantly more hairs than boys did, and they did so in a significantly progressive manner with age. This phenomenon, which had already been observed by some of us, 12 is probably related to the fact that puberty is not a sharply defined phenomenon but in girls starts long before the menarche and progresses at a different pace in the various subjects. Hair shedding reflects not only these different rates of progression but also probably the presence, in various degrees, of the AGA genotype as well.…”

<p>Telogen effluvium: a comprehensive review</p>

“…The method is apparently simplistic, but it is easily accepted by the patients, provides important information and, instead of histopathology, may be repeated every month to monitor the disorder 10. Prepubertal children who, because of the absence of 5 alfa reductase, must be considered as “normal” from the AGA point of view at least, shed under standardized condition, only 10.68±3.91 hairs every 5 days,11 a number very far from the 100 a day claimed elsewhere to be the “normality” 12…”

Hair Evaluation Method: Pull Test and Wash Test

“…In physiology, the wash test performed well in an attempt to establish the "normal" shedding (Rampini et al 1999). In a group of prepubertal children of both genders, free from five alpha reductase and therefore of AGA, we were able to verify that "normally" they shed 10.68 AE 3.01 hairs, a number that steadily increases up to 11 years when puberty is approaching (Fig.…”