| By :
Danny Grant
The majority of hair loss that we see in children is alopecia areata, or something that started as areata and then spread to larger sections of the scalp, where it takes on names like alopecia totalis or alopecia ophiasis. Alopecia areata need not just develop on the scalp. It can start off in the eyebrows for example or eye lashes. What can a parent do? Parents often try to look for what triggered the problem, where in reality no one actually knows and the treatment options remain the same. The usual starting place is taking the child to a doctor to establish what is wrong. In most cases this is done just by looking at the pattern of hair loss. A punch biopsy in the region of loss is the only fool-proof method of confirming a definite diagnosis. Parents and doctors alike usually avoid putting a child through this because it is upsetting to the child. Doctors usually refer the child to a dermatologist and this is where we often see a lot of anxiety. It is common to see the problem progressing whilst waiting for an appointment with a busy dermatologist. A high percentage of children's hair loss cases get better on their own without treatment. However because some progress through to a stage where all scalp and facial is lost permanently, parents quite rightly are rather anxious. Many parents assume that the dermatologist is able to predict the outcome of their child's alopecia, which actually is impossible to do correctly. Treatment The most common treatment we see for alopecia areata is that of suppressing the immune system with topical steroid creams or injections. As steroids are known to cause some side effects and are not normally safe to use for long periods of time, many doctors will often avoid using them to see if the problem clears up on its own. To the parent, this adds to their anxiety: In many cases it has taken many weeks to get to see a dermatologist only to be told that there will be no treatment available at that point. Other parents are prescribed steroids, but when they read the list of side effects they are then too nervous to start using them. Where to turn to for support That is why we find so many parents turning to the internet for support and advice. It is much easier to come to terms with the disease if you know other parents have been through the emotions you are experiencing and you can learn from their experience in beating the hair loss. A very good example is how new hair looks when it starts to regrow: translucent and baby fine. Any mother that has seen a child recover from alopecia areata knows that this baby fine hair is actually a very good sign: It may be of limited value cosmetically, however it means that the immune system has stopped attacking the keratinocytes (building blocks of the hair) and it will just be a matter of time for the melanocytes (these are like little colour factories ) to recover from the immune assault. However as around only 1% of the hair is actually comprised of melanin (coloured portion) it means that you are 99% on the way to recovering from the problem. Another example is that in advanced cases where the hair is lost from the entire scalp, it is usually the very top of the scalp that grows back the fastest. It follows that knowing this and being able to see pictures of similar recovery patterns helps to put ones mind at rest. What matters most is knowing what to expect and being aware that you are making positive progress. The final piece that it is useful to know, is that often a patch will start to regrow and other new ones form or new ones form before all the patches recover. This can happen if the child is being treated or not. Many parents panic at this point and assume they have used the wrong treatment approach rather than accept that it is just how this disease normally behaves.
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