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What a “Bald Spot” Can Mean for Kids

by Sue Hubbard, M.D.

I saw a patient the other day whose mother brought him into the office after her son had found a “bald spot” on his head.

It is alarming for parents or a child to find an area of hair loss or a “bald spot” on their head. One of the reasons for hair loss is called alopecia areata.

Alopciea areata is a non-scarring, solitary or multiple circular patch of hair loss. The areas are often described as “coin-shaped”, often the size of a nickel or quarter, but may be larger.

Alopecia areata is an immune disorder typically seen in children and adolescents. It can run in families and stress may play a role as a trigger.

The areas exhibit no scaling, scabbing or irritation, there is simply hair loss. In older adolescents and young adult males the disorder can occur in the beard areas around areas of hair loss. Most of the lesions will resolve within a year, but patients often have repeat episodes. Rarely the hair loss can progress to total loss of scalp and body hair.

Parents often confuse the hair loss with the fungal disease known as “ringworm”, but alopecia areata is not related to a fungus or any other known contagious disorder.

There is no cure for Alopecia areata, but there is treatment. The most common treatment consists of steroid injections into the areas. There can be significant psychological issues associated with the cosmetic consequences of alopecia areata and parents should be aware of that when deciding whether to treat the areas or wait for spontaneous resolution. In this case I sent him on to a dermatologist for further evaluation and treatment.

The good news is that the majority of cases will resolve. Like so many things it takes time and patience and that is hard to have if you are a teen with hair loss.

That’s your daily dose, we’ll chat again tomorrow.

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