New session untangles roots of hair loss in children

The reason for hair loss in children is not always straightforward. The new Thursday session, Don’t Brush it Off: Diagnosis and Management of Hair Loss in Children (U002), reveals clues to uncommon causes.

Brittany Craiglow, MD

Session director Brittany Gareth Craiglow, MD, said the session will explore specific indicators that point to something beyond a standard diagnosis for a child’s hair loss, such as tinea capitis or alopecia areata. Presenters will also review other less common conditions, including loose anagen hair syndrome, lichen planopilaris, and androgenetic alopecia, as well as discuss medical therapies for those conditions. In particular, they will present a management algorithm and discuss the use of Janus kinase inhibitors for the treatment of alopecia areata in children.

Treatment options for hair loss in children vary, she said.

“For non-infectious causes of hair loss like alopecia areata or androgenetic alopecia, there is no one-size-fits-all treatment,” said Dr. Craiglow. “The patient’s age, extent of disease, and psychosocial impact are all important aspects to consider when determining a therapeutic approach.”

She offered some clues for identifying the need for additional diagnostic exams on children with hair loss.

“A fungal culture is important for patients presenting with scalp scale and hair loss,” Dr. Craiglow said. “A hair-pull is useful in cases of suspected loose anagen syndrome. And a scalp biopsy may be necessary in cases where there is not a clear diagnosis and is essential if there is any evidence of scarring.”

When caring for young patients with hair loss, Dr. Craiglow said there are other personal considerations beyond the correct diagnosis and treatment.

“Hair loss is often emotionally devastating for patients and families, but unfortunately they often feel dismissed by health care providers,” she said. “In addition to determining the appropriate medical therapy, it is important to inquire about a patient’s overall quality of life, acknowledge, and normalize their feelings surrounding their condition, and address misconceptions.”

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