Abstract
Hair loss in children causes great emotional impact in both patients and relatives. Particularities of this age group along with the lack of clinical trials make therapy in children many times challenging for physicians. In this chapter, we discuss treatments of common types of hair loss in children such as tinea capitis, alopecia areata, trichotillomania, hair shaft disorders, and others based on current literature and experience.
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References
Castelo-Soccio L. Diagnosis and management of alopecia in children. Pediatr Clin N Am. 2014;61:427–42.
Elghblawi E. Tinea capitis in children and trichoscopic criteria. Int J Trichol. 2017;9(2):47–9.
Gupta AK, Mays RR, Versteeg SG, Piraccini BM, Shear NH, Piguet V, et al. Tinea capitis in children: a systematic review of management. J Eur Acad Dermatol Venereol. 2018;32(12):2264–74.
Chen X, Jiang X, Yang M, Bennett C, González U, Lin X, et al. Systemic antifungal therapy for tinea capitis in children: an abridged cochrane review. J Am Acad Dermatol. 2017;76(2):368–74.
Bijanzadeh M, Mahmoudian M, Salehian P, Khazainia T, Eshghi L, Khosravy A. The bioavailability of griseofulvin from microsized and ultramicrosized tablets in nonfasting volunteers. Indian J Physiol Pharmacol. 1990;34(3):157–61.
Fuller LC, Barton RC, Mohd Mustapa MF, Proudfoot LE, Punjabi SP, Higgins EM. British Association of Dermatologists’ guidelines for the management of tinea capitis 2014. Br J Dermatol. 2014;171(3):454–63.
Gupta AK. Systemic antifungal agents. In: Wolverton SE, editor. Comprehensive dermatologic drug therapy. 3rd ed. Philadelphia: Elsevier; 2013. p. 98–120.
Chen S, Sun KY, Feng XW, Ran X, Lama J, Ran YP. Efficacy and safety of itraconazole use in infants. World J Pediatr. 2016;12(4):399–407.
Koumantaki-Mathioudaki E, Devliotou-Panagiotidou D, Rallis E, Athanassopoulou V, Koussidou-Eremondi T, Katsambas A, et al. Is itraconazole the treatment of choice in Microsporum canis tinea capitis? Drugs Exp Clin Res. 2005;31 Suppl:11–5.
Binder B, Richtig E, Weger W, Ginter-Hanselmayer G. Tinea capitis in early infancy treated with itraconazole: a pilot study. J Eur Acad Dermatol Venereol. 2009;23:1161–3.
Foster KW, Friedlander SF, Panzer H, Ghannoum MA, Elewski BE. A randomized controlled trial assessing the efficacy of fluconazole in the treatment of pediatric tinea capitis. J Am Acad Dermatol. 2005;53(5):798–809.
Peloquin L, Castelo-Soccio L. Alopecia areata: an update on treatment options for children. Pediatr Drugs. 2017;19:411–22.
Alkhalifah A, Alsantali A, Wang E, Kevin J, McElwee KJ, Shapiro J. Alopecia areata update. Part I. Clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol. 2010;62(2):191–202.
Waśkiel A, Rakowska A, Sikora M, Olszewska M, Rudnicka L. Trichoscopy of alopecia areata: an update. J Dermatol. 2018;45(6):692–700.
Lenane P, Macarthur C, Parkin PC, Krafchik B, DeGroot J, Khambalia A, et al. Clobetasol propionate, 0.05%, vs hydrocortisone, 1%, for alopecia areata in children. A Randomized Clinical Trial. JAMA Dermatol. 2014;150(1):47–50.
Iorizzo M, Oranje AP. Current and future treatments of alopecia areata and trichotillomania in children. Expert Opin Pharmacother. 2016;17(13):1767–73.
Salsberg JM, Jeff Donovan J. The safety and efficacy of diphencyprone for the treatment of alopecia areata in children. Arch Dermatol. 2012;148(9):1084–5.
Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update: part II. Treatment. J Am Acad Dermatol. 2010;62(2):191–202.
Wu SZ, Wang S, Ratnaparkhi R, Bergfeld WF. Treatment of pediatric alopecia areata with anthralin: a retrospective study of 37 patients. Pediatr Dermatol. 2018;35(6):817–20.
Özdemir M, Balevi A. Bilateral half-head comparison of 1% anthralin ointment in children with alopecia areata. Pediatr Dermatol. 2017;34(2):128–32.
Daunton A, Harries M. Efficacy of topical dithranol (Dithrocream®) in the treatment of alopecia areata: a retrospective case series. Br J Dermatol. 2019;180(5):1246–7.
Durdu M, Özcan D, Baba M, Seçkin D. Efficacy and safety of diphenylcyclopropenone alone or in combination with anthralin in the treatment of chronic extensive alopecia areata: a retrospective case series. J Am Acad Dermatol. 2015;72(4):640–50.
Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM, et al. Alopecia areata: an appraisal of new treatment approaches and overview of current therapies. J Am Acad Dermatol. 2018;78(1):15–24.
Bayart CB, DeNiro KL, Brichta L, Craiglow BG, Sidbury R. Topical Janus kinase inhibitors for the treatment of pediatric alopecia areata. J Am Acad Dermatol. 2017;77(1):167–70.
Craiglow BG, Tavares D, King BA. Topical ruxolitinib for the treatment of alopecia Universalis. JAMA Dermatol. 2016;152(4):490–1.
Georgala S, Befon A, Maniatopoulou E, Georgala C. Topical use of minoxidil in children and systemic side effects. Dermatology. 2007;214(1):101–2.
Talpur R, Vu J, Bassett R, Stevens V, Duvic M. Phase I/II randomized bilateral half-head comparison of topical bexarotene 1% gel for alopecia areata. J Am Acad Dermatol. 2009;61(4):592.e1–9.
Zaher H, Gawdat HI, Hegazy RA, et al. Bimatoprost versus mometasone furoate in the treatment of scalp alopecia areata: a pilot study. Dermatology. 2015;230:308–13.
Li AW, Antaya RJ. Successful treatment of pediatric alopecia areata of the scalp using topical bimatoprost. Pediatr Dermatol. 2016;33(5):e282–3.
Chu TW, AlJasser M, Alharbi A, Abahussein O, McElwee K, Shapiro J. Benefit of different concentrations of intralesional triamcinolone acetonide in alopecia areata: an intrasubject pilot study. J Am Acad Dermatol. 2015;73:338–40.
Sharma VK, Muralidhar S. Treatment of widespread alopecia areata in young patients with monthly oral corticosteroid pulse. Pediatr Dermatol. 1998;15(4):313–7.
Friedland R, Tal R, Lapidoth M, Zvulunov A, Ben Amitai D. Pulse corticosteroid therapy for alopecia areata in children: a retrospective study. Dermatology. 2013;227(1):37–44.
Lalosevic J, Gajic-Veljic M, Bonaci-Nikolic B, Nikolic M. Combined oral pulse and topical corticosteroid therapy for severe alopecia areata in children: a long-term follow-up study. Dermatol Ther. 2015;28(5):309–17.
Shreberk-Hassidim R, Ramot Y, Gilula Z, Zlotogorski A. A systematic review of pulse steroid therapy for alopecia areata. J Am Acad Dermatol. 2016;74(2):372–4.e1–5.
Royer M, Bodemer C, Vabres P, Pajot C, Barbarot S, Paul C, et al. Efficacy and tolerability of methotrexate in severe childhood alopecia areata. Br J Dermatol. 2011;165(2):407–10.
Chandran NS, Novak J, Iorizzo M, Grimalt R, Oranje AP. Trichotillomania in children. Skin Appendage Disord. 2015;1(1):18–24.
Alves R, Grimalt R. Hair loss in children. Curr Probl Dermatol. 2015;47:55–66.
Rakowska A, Slowinska M, Olszewska M, Rudnicka L. New trichoscopy findings in trichotillomania: flame hairs, V-sign, hook hairs, hair powder, tulip hairs. Acta Derm Venereol. 2014;94(3):303–6.
De Sousa A. An open-label pilot study of naltrexone in childhood-onset trichotillomania. J Child Adolesc Psychopharmacol. 2008;18(1):30–3.
Grant JE, Odlaug BL, Kim SW. N-acetylcysteine, a glutamate modulator in the treatment of trichotillomania. A double-blind, placebo-controlled study. Arch Gen Psychiatry. 2009;66(7):756–63.
Bloch MH, Panza KE, Grant JE, Pittenger C, Leckman JF. N-acetylcysteine in the treatment of pediatric trichotillomania: a randomized, double-blind, placebo-controlled add-ontrial. J Am Acad Child Adolesc Psychiatry. 2013;52(3)
Yamazaki M, Irisawa R, Tsuboi R. Temporal triangular alopecia and a review of 52 past cases. J Dermatol. 2010;37:360–2.
Trakimas CA, Sperling LC. Temporal triangular alopecia acquired in adulthood. J Am Acad Dermatol. 1999;40(5 Pt 2):842–4.
Yin Li VC, Yesudian PD. Congenital triangular alopecia. Int J Trichol. 2015;7(2):48–53.
Fernández-Crehuet P, Vaño-Galván S, Martorell-Calatayud A, Arias-Santiago S, Grimalt R, Camacho-Martínez FM. Clinical and trichoscopic characteristics of temporal triangular alopecia: a multicenter study. J Am Acad Dermatol. 2016;75(3):634–7.
Bang CY, Byun JW, Kang MJ, Yang BH, Song HJ, Shin J, et al. Successful treatment of temporal triangular alopecia with topical minoxidil. Ann Dermatol. 2013;25:387–8.
Wu WY, Otberg N, Kang H, Zanet L, Shapiro J. Successful treatment of temporal triangular alopecia by hair restoration surgery using follicular unit transplantation. Dermatol Surg. 2009;35(8):1307–10.
AlShehri W, AlFadil S, AlOthri A, Alabdulkarim AO, Wani SA, Rabah SM. Aplasia cutis congenita of the scalp with a familial pattern: a case report. World J Plast Surg. 2016;5(3):298–302.
Kruk-Jeromin J, Janik J, Rykała J. Aplasia cutis congenita of the scalp. Report of 16 cases. Dermatol Surg. 1998;24(5):549–53.
Rakowska A, Maj M, Zadurska M, Czuwara J, Warszawik-Henzel O, Olszewska M, et al. Trichoscopy of focal alopecia in children - new trichoscopic findings: hair bulbs arranged radially along hair-bearing margins in aplasia cutis congenita. Skin Appendage Disord. 2016;2(1–2):1–6.
Tosti A. Pediatric hair disorders. In: Tosti A, editor. Dermoscopy of the hair and nails. 2nd ed. Boca Raton, FL: CRC Press; 2016. p. 79–85.
Frieden IJ. Aplasia cutis congenita: a clinical review and proposal for classification. J Am Acad Dermatol. 1986;14(4):646–60.
Belkhou A, François C, Bennis Y, Duquennoy-Martinot V, Guerreschi P. Aplasia cutis congenita: update and management. Ann Chir Plast Esthet. 2016;61(5):450–61.
Miteva M, Tosti A. Dermatoscopy of hair shaft disorders. J Am Acad Dermatol. 2013;68:473–81.
Singh G, Miteva M. Prognosis and management of congenital hair shaft disorders with fragility-part I. Pediatr Dermatol. 2016;33(5):473–80.
Rudnicka L, Olszewska M, Waśkiel A, Rakowska A. Trichoscopy in hair shaft disorders. Dermatol Clin. 2018;36:421–30.
Rakowska A, Slowinska M, Kowalska-Oledzka E, Rudnicka L. Trichoscopy in genetic hair shaft abnormalities. J Dermatol Case Rep. 2008;2:14–20.
Mirmirani P, Huang KP, Price VH. A practical, algorithmic approach to diagnosing hair shaft disorders. Int J Dermatol. 2011;50(1):1–12.
Singh G, Miteva M. Prognosis and management of congenital hair shaft disorders without fragility-part II. Pediatr Dermatol. 2016;33(5):481–7.
Cheng AS, Bayliss SJ. The genetics of hair shaft disorders. J Am Acad Dermatol. 2008;59(1):1–22.
Karincaoglu Y, Coskun BK, Seyhan ME, Bayram N. Monilethrix: improvement with acitretin. Am J Clin Dermatol. 2005;6(6):407–10.
De Berker D, Dawber RP. Monilethrix treated with oral retinoids. Clin Exp Dermatol. 1991;16(3):226–8.
Rossi A, Iorio A, Scali E, Fortuna MC, Mari E, Palese E, et al. Monilethrix treated with minoxidil. Int J Immunopathol Pharmacol. 2011;24(1):239–42.
Sun JD, Linden KG. Netherton syndrome: a case report and review of the literature. Int J Dermatol. 2006;45(6):693–7.
Itin PH, Sarasin A, Pittelkow MR. Trichothiodystrophy: update on the sulfur-deficient brittle hair syndromes. J Am Acad Dermatol. 2001;44(6):891–920; quiz 921–4.
Faghri S, Tamura D, Kraemer KH, Digiovanna JJ. Trichothiodystrophy: a systematic review of 112 published cases characterises a wide spectrum of clinical manifestations. J Med Genet. 2008;45(10):609–21.
Richards KA, Mancini AJ. Three members of a family with pili torti and sensorineural hearing loss: the Bjornstad syndrome. J Am Acad Dermatol. 2002;46(2):301–3.
Telfer NR, Cutler TP, Dawber RP. The natural history of ‘dystrophic’ pili torti. Br J Dermatol. 1989;120(2):323–5.
Ferrando J, Grimalt R. Pediatric hair disorders: an atlas and text. 3rd ed. Boca Raton, FL: CRC Press; 2017. p. 1–35.
Albers LN, Maley AM, MacKelfresh JB. Blowing bubbles: dermoscopy of bubble hair. Int J Trichol. 2017;9(3):122–3.
Castelli E, Fiorella S, Caputo V. Pili annulati coincident with alopecia areata, autoimmune thyroid disease, and primary IgA deficiency: case report and considerations on the literature. Case Rep Dermatol. 2012;4:250–5.
Hicks J, Metry DW, Barrish J, Levy M. Uncombable hair (cheveux incoiffables, pili trianguli et canaliculi) syndrome: brief review and role of scanning electron microscopy in diagnosis. Ultrastruct Pathol. 2001;25(2):99–103.
Calderon P, Otberg N, Shapiro J. Uncombable hair syndrome. J Am Acad Dermatol. 2009;61(3):512–5.
Cho S, Choi MJ, Zheng Z, Goo B, Kim DY, Cho SB. Clinical effects of non-ablative and ablative fractional lasers on various hair disorders: a case series of 17 patients. J Cosmet Laser Ther. 2013;15(2):74–9.
Cantatore-Francis JL, Orlow SJ. Practical guidelines for evaluation of loose anagen hair syndrome. Arch Dermatol. 2009;145(10):1123–8.
Mirmirani P, Uno H, Price VH. Abnormal inner root sheath of the hair follicle in the loose anagen hair syndrome: an ultrastructural study. J Am Acad Dermatol. 2011;64(1):129–34.
Tosti A, Piraccini BM. Loose anagen hair syndrome and loose anagen hair. Arch Dermatol. 2002;138(4):521–2.
Oberlin KE, Maddy AJ, MartınezVelasco MA, Vazquez-Herrera NE, Schachner LA, Tosti A. Short anagen syndrome: case series and literature review. Pediatr Dermatol. 2018;00:1–4.
Herskovitz I, de Sousa IC, Simon J, Tosti A. Short anagen hair syndrome. Int J Trichol. 2013;5(1):45–6.
Giacomini F, Starace M, Tosti A. Short anagen syndrome. Pediatr Dermatol. 2011;28(2):133–4.
Cheng YP, Chen YS, Lin SJ, Hsiao CH, Chiu HC, Chan JL. Minoxidil improved hair density in an Asian girl with short anagen syndrome: a case report and review of literature. Int J Dermatol. 2016;55(11):1268–71.
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Salas-Callo, C.I., Pirmez, R. (2020). Treatment in Children. In: Tosti, A., Asz-Sigall, D., Pirmez, R. (eds) Hair and Scalp Treatments. Springer, Cham. https://doi.org/10.1007/978-3-030-21555-2_16
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DOI: https://doi.org/10.1007/978-3-030-21555-2_16
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