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Hair Loss in Children: A Clinicoetiological Study from South India
Varsha M Shetty1, Asha Gowrappala Shanmukhappa1, H V Nataraj1
1Department of Dermatology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
Insights
Pediatric scalp hair loss, often presenting asymptomatically and in a patchy pattern, is frequently acquired rather than congenital. Common causes include tinea capitis and alopecia areata, highlighting the importance of diagnostic tests.
Area of Science:
- Pediatric Dermatology
- Trichology
Background:
- Scalp hair loss is a common pediatric dermatological complaint with significant psychological impact.
- Accurate diagnosis is crucial due to the cosmetic importance of hair in children.
Purpose of the Study:
- To investigate the diverse causes and clinical presentations of scalp hair loss in children.
- To provide a comprehensive understanding of pediatric alopecia in the Indian population.
Main Methods:
- A hospital-based descriptive study involving 170 children with scalp hair loss.
- Utilized detailed history, scalp/hair examination, bedside investigations (KOH mount, hair shaft microscopy, hair pull tests), and scalp biopsy/dermoscopy when indicated.
Main Results:
- The majority of cases (62.4%) involved school-going children and adolescents.
- Asymptomatic, patchy, acquired hair loss was most common (71.2%, 86.5%, 89.4% respectively).
- Key causes included neonatal occipital alopecia (congenital), tinea capitis, alopecia areata, and telogen effluvium (acquired nonscarring).
Conclusions:
- Childhood alopecia differs from adult patterns in etiology and presentation.
- Simple diagnostic tests like KOH mount and hair shaft microscopy are vital for diagnosing common pediatric hair loss.
- This study offers valuable insights into pediatric alopecia in India, addressing a gap in existing literature.
Background:
Scalp hair loss in children is one of the common complaints encountered in dermatological practice. Accurate diagnosis of hair loss in children is of major significance as it can have severe psychological implications given the cosmetic importance of hair.
Aims:
This study aims to study the different causes and clinical presentations of scalp hair loss in children.
Materials And Methods:
This was a hospital-based descriptive study that enrolled a total of 170 children with scalp hair loss. A detailed history, scalp, and hair examination were done. Bedside investigations such as KOH mount, hair shaft microscopy, and hair pull tests were conducted. Scalp biopsy and dermoscopy were done wherever necessary to confirm the diagnosis.
Results:
Majority of the children with scalp hair loss were school going and adolescents accounting for 62.4% of cases; 52.4% of patients were male and 47.6% were female. Asymptomatic hair loss was the most common presenting complaint contributing to 71.2% of cases. Patchy pattern of scalp hair loss formed a majority (86.5%) compared to diffuse pattern (13.5%). Around 89.4% of scalp hair loss were of acquired type and remaining 10.6% were of congenital type. Neonatal occipital alopecia (38.9%) was the most common cause of congenital hair loss. However, in the acquired group, 90.1% had nonscarring and 9.9% had scarring alopecia. In the nonscarring group, tinea capitis, alopecia areata, and telogen effluvium accounted for 47.4%, 37.9%, and 8.8% of cases, respectively.
Conclusion:
Childhood alopecia is different from adult alopecia in terms of causes and the pattern of presentation. There is a scarcity of literature on childhood alopecia from India, hence, this study can serve as a useful guide in understanding the different causes and its presentation in our population. In addition, this study signifies the importance of simple diagnostic tests such as KOH and hair shaft microscopy in the diagnosis of common hair loss conditions in children.
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