Traction alopecia: Help, my child’s hair is falling out!

Is your child’s hair falling out? Hair loss in children could be caused by a condition known as ‘traction alopecia’.

Traction alopecia is caused by heat, chemicals, and tight styles that pull at your child’s hair root, including some braids, dreadlocks, extensions, and weaves.  Ethnic children are more prone to the condition because their hair texture is naturally curly and more fragile. Because of bends in the hair, sebum from the scalp, a natural protectant, can’t travel down the length of the shaft. The bends themselves also make curly hair prone to breakage.

We chat with Rani Chetty, founder of Tymeless Necessity Hair – a proud partner of Cancer South Africa (CANSA) – about this relatively common condition in children.

How to spot hair loss in kids

Hair loss happens in phases. Pain and little bumps around the follicle, called traction folliculitis, are the first signs that a style is too tight. When the follicle is put under repeated tension, it scars over and hair stops growing permanently. This is called scarring alopecia. If your little girl wears tight braids or ponytails, you might be pulling on the hair follicles too forcefully for them to cope. You’ll be able to spot hair loss where the hair is most commonly pulled, carries the most weight, or possibly on the back of the head where the braids rub against the pillow while sleeping.

Signs of traction alopecia

• A receding hairline typically around the forehead, temples, or nape.
• Small pimples appear on the scalp or at the base of braids.
• Redness, itching, and ulcers on the scalp.
• The hair parting widens.
• Patches of thin or broken hair in places where the hair has been under strain.

Traction alopecia can happen slowly, so it may take some time for you to notice that your child’s hairline has started to recede. If you’re starting to notice thin edges or bald spots on your daughter’s hair, definitely see a dermatologist first. It’s important to get a diagnosis.

6 Ways to protect your child’s hair from traction alopecia

1. Go cold turkey of braids or dreadlocks, especially if your child is suffering from hair loss.
2. If your child has braids, make sure they are professionally removed after a maximum of three months.
3. If your child wears a weave or hair extensions, make sure they are professionally removed after a maximum of eight weeks.
4. If your child has relaxed hair, make sure these treatments are applied by a professional ONLY. If you still notice breakage or hair shedding, avoid chemical treatments on your child’s hair completely.
5. Minimise (or completely avoid) heat styling on your child’s hair, including hairdryers, flat irons, and curling irons. These wear out the hair and can lead to major hair loss.
6. Avoid styling your child’s hair while it’s wet as this can cause it to stretch and break. Instead, style your child’s hair when it’s dry or damp. Avoid teasing or back-combing your child’s hair because they can cause damage.

Good to know: Massaging your child’s scalp can help to restore hair growth and can be used in conjunction with hair oils and masks. This stimulates the scalp and can improve hair thickness. Taking the time to massage your child’s scalp each day can also help your child to relieve stress and tension. It’s thought that stretching forces during the massage encourage hair growth and thickness in the dermal papilla cells. Essential oils including thyme, rosemary, cedarwood, and peppermint to parents of children who have no underlying medical conditions can be used. Just keep in mind that essential oils are very strong so they must be diluted with inactive oils like grape seed, coconut, or olive oil.

Facts on traction alopecia

• Traction alopecia (TA) affects one-third of children of African descent who wear various forms of traumatic hairstyling for a prolonged period of time.
• The risk of TA is increased by the extent of pulling and duration of traction, as well as the use of chemical relaxation.
• Traction alopecia can be reversed if you stop pulling your child’s hair back. But if you don’t intervene soon enough, the hair loss may be permanent.
• Traction alopecia is often resolved within six months if it is caught and treated early. In severe cases, it can take as long as one year for a damaged scalp to regrow hair.
• When hair follicles are badly traumatised over a long period and scar tissue has formed, the hair will not grow back by itself.

Other conditions that can cause hair loss in children

Tinea capitis: Tinea capitis, commonly known as ringworm of the scalp, is a fungal infection often seen in children. It can show up in several ways, but often as scaly patches of hair loss on the head. The patches are usually round or oval. The hairs may be broken off at the surface of the skin and look like black dots on the scalp.

Alopecia areata: Alopecia areata is a non-contagious condition of hair loss thought to be caused by the body’s immune system attacking the hair follicles. It is characterized by the sudden appearance of round or oval patches of hair loss. The patches are slick or smooth, without scaling or broken hairs. About 25% of children also have pitting and ridging of the nails. Trichotillomania is hair loss caused by the child pulling, plucking, twisting, or rubbing his or her hair. The hair loss is patchy and characterized by broken hairs of varying lengths. Patches are typically seen on the side of the child’s dominant hand.

Telogen effluvium: Telogen effluvium is a condition in which sudden or severe stress interrupts the normal cycle of hair growth. The hair follicles stop growing prematurely and enter a resting phase (called the telogen phase). Between six and 16 weeks later, hair sheds excessively, leading to partial or complete baldness.

Deficiencies: Deficiencies in certain nutrients can also cause childhood hair loss, including Vitamin H, Zinc, and Vitamin A. Unfortunately, certain types of hair loss are also genetic, and very little can be done to prevent them. Genetic types of hair loss include alopecia areata and female pattern hair loss.