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Causes of Localized Hair Loss in Children

American Family Physician, March 15, 1999 by Anne D. Walling

(Australia -- Australian Family Physician, October 1998, p. 954.) The most common cause of localized alopecia in children is repeated hair- pulling (trichotillomania), which produces irregularly shaped areas of incomplete alopecia containing damaged hairs of various lengths. The scalp usually appears normal but may show petechiae or pustules secondary to trauma.

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The scalp also appears normal in children with alopecia areata, but this condition produces a clearly circumscribed area of complete hair loss bordered by pathognomonic "exclamation point" hairs that are wider at the tip than close to the scalp. Hair loss that is secondary to dermatophyte scalp infection (tinea capitis) is associated with inflammation and scaling of the scalp with broken infected hairs either at the scalp level or close to the hair root. The scalp may appear to have black dots, which are caused by the stubble of broken hairs. Alopecia that is present from birth may result from in utero scarring (aplasia cutis) or nevus sebaceous, which has an orange, velvety appearance and becomes more prominent and wart-like during adolescence because of increased sebaceous activity.

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Causes of Localized Hair Loss in Children

American Family Physician, March 15, 1999 by Anne D. Walling

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