Alopecia, often known as hair loss, is a typical complaint in dermatology clinics. This hair loss can be brought on by various illnesses, each of which is characterized by a particular diagnosis. Dermatologists see a lot of patients who have androgenetic alopecia, which is the most prevalent kind of hair thinning in adults.
Similarly, hair loss in children and adolescents is not an uncommon problem, but the patterns that occur are distinct from those observed in adults. Furthermore, this issue is of particular concern in the pediatric population because it is linked to more serious psychological repercussions in this age group.
The conditions trichotillomania, telogen effluvium, bacterial infections, tinea capitis, traction alopecia, and alopecia areata are among the most frequent cause of hair thinning in children. Other, less common reasons for hair loss include thyroid problems, diseases like SLE or diabetes or anemia from a lack of iron in the diet, or abnormal shaft development that leads to brittleness and breakage. Ethnic groups affect the sorts of hair that people have, and the way that people’s hair looks varies from place to place. Consequently, the reasons people lose their hair vary, both in common causes and less common ones.
What Signs and Symptoms Are Associated with Alopecia Areata?
Alopecia areata frequently manifests itself on the scalp as the abrupt appearance of bald patches that are smooth and circular. The affected regions are typically the color of the skin. However, they may also have a pinkish hue. At times, there may be a few white or short colored hairs sprinkled throughout the hairless region.
Alopecia areata is distinguished from other forms of baldness by the absence of redness and scaling on the skin’s surface. In children, the first sign of the condition is typically the appearance of one to multiple tiny patches on the scalp. However, some children experience a faster hair loss that affects practically the entirety of their scalp and their eyelashes, eyebrows, and body hair. The surface of your child’s nails might exhibit a few little pits here and there.
Types Of Alopecia Areata
There are several subtypes of alopecia areata. You can distinguish each type from the others based on the severity of hair thinning and any other symptoms that may be present. The treatment and prognosis for each subtype may also be slightly different.
Areata (Patchy)
The presence of one or multiple coin-sized bald patches on the scalp or body is the primary indicator of the patchy variety of alopecia areata, a subtype of the condition. If this condition continues to worsen, it has the potential to develop into alopecia Universalis or alopecia totalis.
Totalis
Alopecia totalis describes a condition in which a person experiences hair loss across their scalp. A total and permanent loss of head hair is the most prominent sign that someone has alopecia totalis.
You may notice your hair falling out in patches at first. Over time, these bald spots will eventually cover the entire head. The loss of hair can start unexpectedly and progress quite quickly. It’s possible that having alopecia totalis will also leave your nails brittle and pitted.
Universalis
People with alopecia Universalis lose hair from their scalp and face, including their eyebrows and eyelashes. Alopecia Universalis results in complete baldness across the body. The name ophiasis comes from the Greek term ophis, meaning “snake.” It refers to the snake-like spread of the condition, particularly over the ears and lateral portions of the scalp.
Diffuse
Also termed alopecia areata incognita. A recent study shows diffuse alopecia areata can have strikingly similar symptoms to male-or-female-pattern hair loss. It leads to an unexpected and sudden thinning of hair across the entirety of the scalp, not just in one particular region.
Ophiasis
“ophiasis alopecia” refers to a pattern of thinning hair that runs in a band down the lower back and sides of the scalp. The prognosis for ophiasis is worse than other alopecia areata. The condition is frequently resistant to traditional treatments such as intralesional, minoxidil, or topical immunotherapy.
Alopecia Areata Prognosis
The outlook for alopecia areata varies for each individual who has the condition. Additionally, it is hard to predict. After you’ve developed this autoimmune disorder, you can suffer from spells of hair thinning and other symptoms connected to it for the rest of your life. On the other hand, some people may never experience hair thinning in their entire lives.
Recuperation
Your hair may grow back entirely for some people but not others. It’s even possible that they’ll lose more hair than usual. People who have alopecia areata are more likely to experience a negative effect on their outlook as a result of several factors, including the following:
- Age of onset
- Severe hair loss
- Nail changes
- Genealogy of the family
- Having many autoimmune diseases
How Do Doctors Determine Whether Someone Has Alopecia Areata?
In most cases, the diagnosis of alopecia areata is based solely on the patient’s clinical presentation; however, further testing could be helpful.
Trichoscopy: A thorough assessment of the hair follicles, hair shafts, and scalp is performed using a dermatoscope. The presence of features such as exclamation point hairs, damaged or dystrophic strands, black dots, and yellow dots are indicators of active disease.
Hair pull test: It can assist in the confirmation of hair thinning and is typically upbeat in cases of alopecia areata. It entails seizing 40–60 hairs clustered closely together and exerting a fair amount of traction. The result is positive when over 10% of the hairs are effortlessly pulled out.
Skin biopsy: If the diagnosis is unclear, it may be necessary. Histopathology reveals what is known as a “bee-swarm pattern” of extensive lymphocytic infiltrates around anagen hair follicles in patients with acute alopecia areata.
As the condition progresses, there are a proportional increase in the number of follicles in the catagen and telogen phases compared to the anagen phase. Follicles also get smaller.
Conclusion
Hair loss in children is relatively common and can be brought on by various conditions. Treatment and diagnosis at an early stage are essential for preventing future hair loss and avoiding irreparable hair damage and alopecia that scars.
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