Hair Loss and its Management in Children

Vibhu Mendiratta; Masarat Jabeen

Disclosures

Expert Rev Dermatol. 2011;6(6):581-590. 

In This Article

Diagnostic Procedures

When tinea capitis is suspected:

  • Fungal culture by scraping the affected areas with a blunt scalpel, a sterile brush or moistened gauze to gather affected hairs;

  • Woods lamp examination: as screening to detect flourescing species, such as Microsporum;

  • A potassium hydroxide preparation (to reveal hyphae): a scalp scraping or plucked hairs from the affected area.

When alopecia areata is suspected:

  • Thyroid function

When telogen effluvium is suspected:

  • Hair pull test (already described);

  • If there is no obvious trigger of telogen effluvium tests include:

    • Sedimentation rate, complete blood count;

    • Serum ferritin;

    • Antinuclear antibody;

    • Thyroid function test;

    • Serology for syphilis.

When scarring alopecias are suspected:

  • 4-mm punch scalp biopsy

When hereditary hair shaft disorders are suspected:

  • Serum biochemistry: for metabolic disorders;

  • To analyze hair structure:

    • Hair mount examination by light and polarizing microscopy;

    • Scanning or transmission electron microscopy, or both.

  • To analyze biochemical composition of affected hair.

    • Amino acid analysis by chromatography, spectroscopy (cysteine and sulfur content);

    • Keratin analysis.

Newer techniques:[7–14]

  • Videodermoscopy: the magnified images of hair follicle are useful for the differential diagnosis between cicatricial and noncicatricial alopecia and between alopecia areata and trichotillomania;

  • Trichoscan: it is an automated software program for the accurate analysis of hair growth and useful in monitoring the response to treatment;

  • Contrast-enhanced phototrichogram: a technique used to analyze hair growth activity using photographic records and a scalp immersion proxigraphy method.

Frequent causes of alopecia encountered in general practice are discussed below.

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