Hair Loss and its Management in Children

Vibhu Mendiratta; Masarat Jabeen


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

In This Article

Diffuse Alopecia (Congenital)

Common causes of congenital diffuse alopecia are discussed below.

Congenital Hypotrichosis & Atrichia

Hereditary simple hypotrichosis is a rare group of familial nonscarring hypotrichosis and atrichias without associated internal abnormalities. Most of them are inherited in an autosomal dominant pattern.[76–78]

Woolly Hair Hypotrichosis

It is characterized by tightly coiled, markedly curly and short hair. It may be associated with eye and teeth defects, deafness, palmoplantar keratoderma and cardiac abnormalies (Naxos disease).

Ectodermal Dysplasias

These genodermatoses are characterized by absent or inadequate development of one or more of the epidermal appendages namely hair, sweat glands, sebaceous glands, nails and teeth.

Genetic Syndromes With Hair Shaft Anomalies

Netherton Syndrome Netherton syndrome is a severe, autosomal recessive form of ichthyosis associated with mutations in the SPINK5 gene with characteristic hair microscopy showing typical nodes resembling bamboo joints. Other features include erythroderma, ichthyosis linearis circumflexa, failure to thrive and atopic state.[79–82]

Menkes Kinky Hair Syndrome Menkes kinky hair syndrome is an X-linked recessive disorder of copper metabolism, characterized by microcephaly, pale skin, silvery brittle scalp hair and progressive neurological deterioration.[83–88]

Trichothiodystrophy Trichothiodystrophy is characterized by trichorrhexis-nodosa like hair fractures due to a defect in synthesis of high-sulfur proteins. It can present as brittle hair, intellectual impairment, decreased fertility, short stature (BIDS), ichthyosis and BIDS or photosensitivity and ichthyosis and BIDS. Polarized microscopy reveals a characteristic tiger-tail pattern.[89]

Isolated Hair Shaft Anomalies

Trichorrhexis Nodosa In light microscopy, trichorrhexis nodosa, shows hair fracture with individual cortical cells and their fragment splaying-out resembles two brushes whose ends are pushed together.[90–92]

Monilethirix Monilethirix is characterized by uniform elliptical nodes and intermittent constrictions ('internodes') along the hair shaft. Clinically it presents as scalp follicular keratosis and hypotrichosis. It can rarely be associated with koilonychia, mental retardation or ectodermal defects.[93]

Pili Torti Pili torti consists of closely grouped twists of hair, occurring in groups of three to ten at irregular intervals along the shaft.


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