PEDIATRIC HAIR LOSS

It is rare that hair loss is obvious to an outside observer, but overall thinning of the hair is very noticeable to teenage girls. They report lots of hairs coming out during a shower or while brushing their hair. The most common reason for this problem is called telogen effluvium. This is when there are more hairs in the resting or telogen phase than is normal, which then fall out. Most people lose 50 to 100 hairs per day, but this can dramatically increase when proportionally more hairs are in the resting phase. This is most often due to physical or psychological stress.

Hair loss can occur after a bad flu, mono, or similar illnesses. The telogen effect occurs about three months after the stressful event so it may not be recalled directly. Certain medication can also cause hair loss, such as lithium or ACE inhibitors that might be prescribed for high blood pressure. Treatment involves stopping the offending medication and reassurance. Androgenetic hair loss is a hormonally mediated condition that may occur in girls with other hormonal problems such as polycystic ovary syndrome (PCOS). Boys can also have early hair loss, which may be familial. It can be treated with topical medications such as minoxidil. Lab tests to rule out medical causes include thyroid function tests and screening for iron deficiency, which is very common in teen girls and may have no other symptoms.

Occasionally teens can develop alopecia areata, which causes a patch of complete baldness. It can even involve the entire scalp or total loss of body hair (alopecia universalis). This is due to an inflammatory condition where immune cells cluster around the roots of the hair, causing it to fall out. It is treatable by a dermatologist via topical or injected steroids, or other topical agents.

Note: None of these conditions are cause for alarm, but hair loss can be an indicator of underlying medical conditions and should be explored with your doctor.