What is alopecia areata?
Alopecia areata is an autoimmune disorder that causes patches of hair to fall out. While it’s rare in children younger than 18 months, it’s most likely to start in childhood and can happen at any age. Alopecia areata affects about 4.5 million people in the United States.
If your baby has this condition, his immune system will attack his hair follicles as if to protect his body from an illness. This attack shrinks the follicles, which then produce hair so slowly that no hair is visible for months or years at a time. Alopecia areata isn’t painful, and it doesn’t mean that your baby is unhealthy.
Your baby may lose hair in just a few patches on his head, or his entire scalp may become bald. Rarely, all of the hair on the body is lost. In all but extreme cases, children with alopecia areata almost always recover at least some of their hair.
What causes alopecia areata?
Researchers don’t know what causes alopecia areata, but genetics plays a role. One in five people with the disorder has a family member who has it, too. It’s also more common in families with a history of asthma, hay fever, atopic eczema, childhood diabetes, or other autoimmune diseases.
It’s possible that an outside factor, like a viral illness, may trigger the condition. While hair loss is often attributed to stress and nervous conditions, alopecia areata isn’t caused by stress.
How can I tell if alopecia areata is what’s causing my child’s hair to fall out?
If your baby is less than 6 months old and is losing his hair, this is most likely not due to alopecia areata. In fact, it’s quite normal for babies to lose their hair at this age for a variety of harmless reasons.
If your baby is older than 6 months and you’ve noticed that clumps of his hair are falling out and round or oval bald patches have suddenly appeared on his head, the problem may be alopecia areata. The exposed scalp will be smooth, and there may be a few shorter, lighter-colored hairs around the edge of the bare area. (If the bald spots are flaky or crusty, your baby may have ringworm instead.) Your baby’s fingernails may be marked by what look like rows of tiny dents.
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Will the hair come back?
The condition is unpredictable, but if the bare patches cover less than half of your baby’s scalp, there’s a good chance that his hair will grow back. Even so, it’s possible for your child to have continuing bouts of alopecia.
In the very rare instances in which a child loses all scalp hair or all body and scalp hair, the hair may never come back. Still, even in these cases, it’s possible for hair to reappear, sometimes after many years.
Keep in mind that if your baby does lose his hair, you’ll want to be especially careful about keeping him protected from the sun. Keep a hat on him or use sunscreen on his scalp as well as the rest of his body.
Is there a cure?
There’s no cure for alopecia areata, although there are treatments that may help stimulate new hair growth. These are most effective in mild cases of the disorder.
If you’re concerned about the amount of hair your baby has lost, make an appointment with his doctor, who may refer you to a dermatologist. Because of concerns about the side effects of treatment, the dermatologist may hesitate to treat children younger than 18 months for this condition.
Once your child is a little older, the doctor may want to treat him with topical cortisone or other creams. The specific treatment will depend on how extensive the condition is. Talk with the dermatologist about the pros and cons of the treatments available.
Where can I get more information?
For more information, write to the National Alopecia Areata Foundation at Box 150760, San Rafael, CA 94915-0760; call the organization at (415) 472-3780; or check out its website.
The National Alopecia Areata Foundation raises money for research, has extensive public awareness and educational programs, and sponsors support groups for patients. Much of its work focuses specifically on children and their families.