Hair Loss/9yr old daughter hair loss
QUESTION: Hi Melanie,
My 9 year old daughter has been losing quite a bit of hair for the past couple of weeks. I'm noticing it on her bed, in the bath and everyday when I sweep our floors. She is not losing it in patches. The bulbs are all on the lost hair. I'm worried. Can you give me some insight as to what may be going on?
6 months ago (Jan), she experienced this also after removing braids she had put in during our vacation to The Dominican. It resolved after a month. Could this have anything to do with it?
Should I be testing her for anything?
ANSWER: Losing hair after removing braids is not uncommon. While the hair is in braids, normal daily shedding still occurs. Because these hair are trapped within the braid they have nowhere to go. All the hair that would have naturally fallen off on a daily basis will come out once the braids are removed. For example, if the braids were in for a week, you may see a weeks worth of shedding. Because of the manipulation and "pulling" on hair follicles, additional hairs may also come out. This would include any hairs that are already in the telogen stage of the hair growth cycle , or any weak, fragile hairs.When braids or other tightly pulled hair styles are worn consistently over a prolonged period of time, a condition called traction alopecia can occur.
Hair grows in cycles. When the hair growth cycle becomes disrupted hair loss can occur. The most common type of hair loss that causes excessive shedding from the roots is telogen effluvium. Any type of change, disturbance or imbalance can cause telogen effluvium. With telogen effluvium the hair growth cycle becomes disrupted. A higher-than-normal amount of hairs retreat to the telogen stage prematurely. In the telogen stage the hair will "rest" within the follicle for approximately three months. After the three month resting period the hair will shed. Looking back to the months prior to the shedding may provide clues. Possible causes include illness, infection, fever, change in diet, medications, vaccination, medical or dental procedure, trauma, stress, etc.
Acute telogen effluvium will resolve on it's own once the body recovers from the insult. If the excessive shedding lasts more than six months, the condition is considered chronic, indicating an internal imbalance that must be identified and addressed.
Although she does not have any bald patches, it is still important to rule out alopecia areata as there are variations of alopecia areata other than the typical bald patches.
Because the hairs all had the bulb on the end, it indicates that the hair went through the telogen stage before falling out. (The bulb develops during telogen) This would rule out certain types of hair loss or breakage.
Feel free to send more information such as how long she wore braids, how tightly pulled, any change that occurred prior to shedding, if she has any other symptoms, any health condition, skin condition, food or environmental allergy, etc. The answers may provide additional clues.
Sincerely, Melanie Vonzabuesnig
---------- FOLLOW-UP ----------
QUESTION: Hi Melanie,
Thanks for all the information. It is very helpful.
My daughter had the braids in for 2 weeks. The braids were tight. My gut is telling me this is the cause for the shedding that is currently going on. She did get sick on our return (probably a bug she picked up in The Dominican), but nothing serious (no fever). She was also sick in Feb (probable flu), as she was ill for a week with fever for 4 days but not a high fever. There is nothing else I can think of that may have triggered this in the past few months. I am hoping this resolves soon. If this is the cause of the braids, is the hair she is losing likely to grow back? I have a blood work request from our family doctor that I am holding onto and a dermatologist apt 3rd week of July. Is there anything I can do in the meantime? Thanks for your help.
Helo Diane: If the hair loss is due to the braids the hair will grow back-- unless the follicles are damaged. It is not likely that the follicles are damaged from a one-time period (of two weeks) of tight braids. Just make sure to keep her hair loosely styled from now on.
You say you are noticing hair on the bed, on floors, etc. If you run your hand through her hair, do you feel that an excessive amount of stands come out with each run through. It would be normal to come up with a few strands during the first run through and possibly the second. You can try it on yourself to compare. In addition to noticing the fallen hairs, do you also notice her hair losing volume? Or does the volume of hair look/feel the same?
It is possible that she is experiencing an episode of acute telogen effluvium. The combination of the trip, bug she caught on trip, illness in February etc. could be enough to cause the hair loss cycle to become temporarily disrupted. Would you say that her health has retuned back to normal since these incidents?
Has the shedding decreased or increased? Remember that we all lose approximately 80 hairs per day. These hairs mostly fall out in the shower, while brushing, or randomly throughout the day.
Make sure you see a dermatologist that has experience with hair loss. Getting the blood work is a good idea.
Please keep me posted.
Sincerely, Melanie Vonzabuesnig