Medical knowledge, Patient Education
Alopecia Areata, Paediatric
Alopecia Areata, Pediatric
Alopecia areata is a condition that causes your child to lose hair. Your child may lose hair on his or her scalp in patches. In some cases, your child may lose all the hair on his or her scalp or all the hair from his or her face and body. Having this condition can be emotionally difficult, but it is not dangerous.
Alopecia areata is an autoimmune disease. This means that your child’s body’s defence system (immune system) mistakes normal parts of the body for germs or other things that can make him or her sick. When your child has alopecia areata, the immune system attacks the hair follicles.
What are the causes?
The cause of this condition is not known.
What increases the risk?
Your child is more likely to develop this condition if he or she has:
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A family history of alopecia.
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A family history of another autoimmune disease, including type 1 diabetes and autoimmune thyroid disease.
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Eczema, asthma, and allergies.
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Down syndrome.
What are the signs or symptoms?
The main symptom of this condition is round spots of patchy hair loss on the scalp. The spots may be mildly itchy. Other symptoms include:
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Short dark hairs in the bald patches that are wider at the top (exclamation point hairs).
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Dents, white spots, or lines in the fingernails or toenails.
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Balding and body hair loss. This is rare.
Alopecia areata usually develops in childhood and is different for each child. For some children, their hair grows back on its own and hair loss does not happen again. For others, their hair may fall out and grow back in cycles. The hair loss may last many years.
How is this diagnosed?
This condition is diagnosed based on your child’s symptoms and family history. Your child’s healthcare provider will also check your child’s scalp skin, teeth, and nails. Your child’s healthcare provider may refer your child to a specialist in children’s hair and skin disorders (paediatric dermatologist).
Your child may also have tests, including:
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A hair pull test.
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Blood tests or other screening tests to check for autoimmune diseases, such as thyroid disease or diabetes.
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Skin biopsy to confirm the diagnosis.
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A procedure to examine the skin with a lighted magnifying instrument (dermoscopy).
How is this treated?
There is no cure for alopecia areata. The goals of treatment are to promote regrowth of hair and prevent the immune system from overreacting. No single treatment is right for all children with alopecia areata. It depends on the type of hair loss your child has and how severe it is.
Work with your child’s healthcare provider to find the best treatment for your child. Treatment may include:
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Regular check-ups to make sure the condition is not getting worse. This is called watchful waiting.
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Using steroid creams or pills for 6–8 weeks to stop the immune reaction and help hair to regrow more quickly.
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Using other medicines on your child’s skin (topical medicines) to change the immune system response and support the hair growth cycle.
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Steroid injections. This treatment is only used in older children.
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Therapy and counselling with a support group or therapist. Children may have trouble coping with hair loss and reactions from others.
Follow these instructions at home:
Medicines
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Apply topical creams only as instructed by your child’s healthcare provider.
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Give your child over-the-counter and prescription medicines only as instructed by your child’s healthcare provider.
General instructions
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Learn as much as you can about your child’s condition.
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Consider getting your child a wig or products to make hair look fuller or to cover bald spots, if your child feels uncomfortable with his or her appearance.
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Educate others about your child’s condition. Let them know that your child is not sick and that alopecia areata is not contagious.
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Get therapy or counselling for your child if your child is having a hard time coping with hair loss. Ask your child’s healthcare provider to recommend a counsellor or a support group.
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Keep all follow-up appointments as instructed by your child’s healthcare provider. This is important.
Where to find more information
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National Alopecia Areata Foundation: naaf.org
Contact a healthcare provider if:
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Your child’s hair loss gets worse, even with treatment.
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Your child has new symptoms.
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Your child is sad or depressed or avoids enjoyable activities.
Get help right away if:
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Your child experiences sudden loss of hair.
Summary
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Alopecia areata is an autoimmune condition that makes your child’s body defence system (immune system) attack the hair follicles. This causes your child to lose hair.
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Alopecia areata is not dangerous but can be emotionally difficult.
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Treatments may include regular check-ups to make sure that the condition is not getting worse (watchful waiting), medicines and steroid injections.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
