Alopecia areata is the group name for the disease and within that group other names are used to describe the extent of the loss, yet it is the same underlying problem: The immune system that has attacked the hair follicle.
Alopecia areata need not just develop on the scalp. It can start off in the eyebrows for example or eye lashes.
What can a parent do?
Parents often try to look for what triggered the problem, where in reality no one actually knows and the treatment options remain the same. The usual starting place is taking the child to a doctor to establish what is wrong. In most cases this is done just by looking at the pattern of hair loss. A punch biopsy in the region of loss is the only fool-proof method of confirming a definite diagnosis. Parents and doctors alike usually avoid putting a child through this because it is upsetting to the child.
Doctors usually refer the child to a dermatologist and this is where we often see a lot of anxiety. Most dermatologists can not be seen immediately and often the parent will see the problem get worse while they await the appointment.
A high percentage of children's hair loss cases get better on their own without treatment. However because some progress through to a stage where all scalp and facial is lost permanently, parents quite rightly are rather anxious. A dermatologist will not be able to predict the outcome of the child's alopecia.
Treatment
The most common treatment we see for alopecia areata is that of suppressing the immune system with topical steroid creams or injections. As steroids are known to cause some side effects and are not normally safe to use for long periods of time, many doctors will often avoid using them to see if the problem clears up on its own.
To the parent, this adds to their anxiety: In many cases it has taken many weeks to get to see a dermatologist only to be told that there will be no treatment available at that point. Other parents are prescribed steroids, but when they read the list of side effects they are then too nervous to start using them.
Where to turn to for support
That is why we find so many parents turning to the internet for support and advice. It is much easier to come to terms with the disease if you know other parents have been through the emotions you are experiencing and you can learn from their experience in beating the hair loss.
An example of this is that when hair does begin to regrow, it is usually very fine and without pigmentation. Any mother that has seen a child recover from alopecia areata knows that this baby fine hair is actually a very good sign: It may be of limited value cosmetically, however it means that the immune system has stopped attacking the keratinocytes (building blocks of the hair) and it will just be a matter of time for the melanocytes (these are like little colour factories ) to recover from the immune assault.
However as around only 1% of the hair is actually comprised of melanin (coloured portion) it means that you are 99% on the way to recovering from the problem.
Similarly when hair is lost from the entire scalp ( alopecia totalis ) you usually see a recovery on the very top of the scalp first and the sides and nape of the neck often take a little longer. It follows that knowing this and being able to see pictures of similar recovery patterns helps to put ones mind at rest. Knowing what to expect and that you are on track that what really matters the most.
The final piece that it is useful to know, is that often a patch will start to regrow and other new ones form or new ones form before all the patches recover. This can happen if the child is being treated or not. It is very easy to panic if you see the problem appearing to get worse and jump to another treatment option rather than hold steadfast.
20 years ago we started to research everything we could on alopecia areata. There reason: we were losing our own hair and hated it. Having solved our own problems, we started to help others and soon the media focused on the work that we were doing to help childrens hair loss. Our website grew out of that work and now acts as a resource centre for those with different forms of hair loss.
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