George, stop pulling your hair out!

The term alopecia refers to hair loss.  There can be multiple causes all of which are bothersome to the affected person.

Causes of alopecia include the following:

Tinea capitis (fungal infection)- Very common cause in children 6 and older, seen more commonly in tightly coiled hair, loss of hair and usually associated with scalp irritation and treated with oral antifungal medications as topical medications are not useful

Alopecia areata- Loss of patches of hair usually with NO scalp irritation and is self-limited (ie without treatment) in the majority of cases

Trichotillomania- Patient is hair pulling, tugging, or twisting the hairs resulting in patchy hair loss with differing lengths and usually on the side of the child’s dominant hand.  Usually brought on by stressful events, divorce, death, etc and often needing psychological intervention to cope with the root causes.

Telogen Effluvium- Hair loss precipitated by moderate to severe stress that can ultimately result in partial or full loss. Lower stress will usually resolve this condition but it is more likely to recur when stress returns.

Nutritional deficiency- This is a rare occurrence and usually only associated with chronic disease such as immunodeficiency or autoimmune conditions that

hypothyroidism- Not so uncommon particularly in teenage girls.  Usually associated with neck fullness (ie goiter), constipation, cold intolerance and less likely depression.