Sarah Gul was horrified when she spotted the bald spots on her five-and-a-half-year-old daughter’s scalp four years ago.
“I thought she might have used a scissor or razor on herself while playing. I asked her and she said she hadn’t. And then the spots started getting bigger.”
Initially, says the 34 year old, she used home remedies for which she found recipes online such as using onion or garlic pulp on the scalp. But when it didn’t help and the number of spots increased, Gul got worried and took her to a dermatologist. “He diagnosed her with alopecia areata,” she tells Gulf News.
The autoimmune condition is one where the body’s immune system begins to attack the hair follicles, resulting in strands falling. The condition has recently been in the spotlight, because of Hollywood star Will Smith’s outburst at the Oscars. His wife, Jada Pinkett Smith, suffers from the same condition and was offended by Chris Rock’s joke at her expense. Will at first laughed it off, then seeing her discomfort, rushed to her defence – and slapped him. Jada and Gul’s daughter are two of 147 million worldwide who have or will develop alopecia areata at some point in their lives, according to US-based National Alopecia Areata Foundation (NAAF).
Gul attested to the fact that losing hair is distressing. “It was very emotionally disturbing for her [now eight-year-old] because initially, the first bald spot she saw was in the front. And I was making her hairstyle in a way that would cover the patch … When it comes to making a hairstyle and going out, she would say, ‘What hairstyle are you making? Is it going to hide my patch?’ Because being a girl, it’s so natural to want lush hair,” says the Sharjah-based expat.
What causes alopecia in kids? Are there different types?
Dr Anuradha Ajesh, Specialist – Paediatrics at Bareen International Hospital, explains that the condition can be caused by a variety of factors in children. These include:
Tinea capitis
Caused by fungal infection (hence contagious) that results to scaly, itchy, or bald patches on the head.
Alopecia areata
Alopecia areata is a non-contagious condition of hair loss thought to be due to body’s immune system attacking the hair follicles. It is characterised by sudden appearance of round or oval hair loss. The patches are smooth, without scales or broken hairs. It is found in 1 in 1000 children.
Traction Alopecia
This condition is from constant tension on the hair due to ponytails, braiding, weaving, and other forms of styling that has pressure.
Trichotillomania
It is caused by the child pulling, plucking, twisting, or rubbing their hair. It is usually patchy and shows broken hairs of varying length.
Telogen effluvium
It is a condition in which a sudden or severe stress such as extremely high fever, surgery under general anaesthesia, the death of a loved one, a severe injury interrupts the normal cycle of hair growth. The hair follicles stop growing prematurely and enter a resting phase (called the telogen phase). Between 6- to 16 weeks later, hair sheds excessively, leading to partial or complete baldness.
Nutritional deficiency
Zinc, Biotin deficiency or excess Vitamin A.
Endocrine problems
This includes hypothyroidism.
How to talk to your child about it
US-based National Alopecia Areata Foundation says that while it’s normal to feel guilt and helplessness as a parent – blaming yourself for your child’s plight – it’s best to be honest and upfront about the condition to your kid. It quotes the American Psychological Association as saying:
- Try not to be overprotective or overly permissive with your child
- Build a support network to manage your own stress and sadness
- Speak to your child directly and frankly about his or her alopecia areata
- Encourage your child to talk to you about his or her feelings living with alopecia areata
“Children with alopecia areata may feel ‘different’ and become socially isolated and overprotected. They may experience fear and frustration related to their condition. Or they may be angry or upset that they ‘got’ alopecia areata. If these feelings are not managed, they can lead to anxiety, sadness, and withdrawal from loved ones or rebelliousness,” says the foundation, adding that a child may also face bullying for looking different.
If you suspect your child is being bullied, adds NAAF, there are ways you can help:
- Work with your child to understand and identify bullying behaviours
- Keep communication with your child open by checking in with them often and listening closely to them
- Encourage your child to participate in activities that he or she enjoys. This will help build friendships and foster confidence
- Be the change by modelling how to treat others with kindness and respect
- Be aware that your child wants you to help them with ideas on how to manage themselves in a bullying situation
- Actively talk with school and youth group leaders about alopecia areata so that they may intervene on behalf of your child
Examples of behaviours often seen in children with depression include
Feeling sad, hopeless, or irritable a lot of the time
Not wanting to do or enjoy doing fun things
Showing changes in eating patterns – eating a lot more or a lot less than usual
Showing changes in sleep patterns – sleeping a lot more or a lot less than normal
Showing changes in energy – being tired and sluggish or tense and restless a lot of the time
Having a hard time paying attention
Feeling worthless, useless, or guilty
Showing self-injury and self-destructive behaviour”
In the case of kids with alopecia areata, says US-based WebMD, about 25 per cent also have pitting and ridging of the nails. And while there is no cure yet for the condition, treatment including steroid creams can help them control the condition.
One such cream was given to Gul by the dermatologist, who told her that there’s no cure for alopecia in allopathy. “What he gave us was a steroid and he said that’s only going to help her grow the hair back, but it’s not going to heal her alopecia in any way. He told us to use as little as we could and only use it until she gets her hair back and then stop using it,” she says.
“It wasn’t really working – we’d use the medicine on one patch and then another patch would appear. So it was one year of struggle. Then when I came to [my home country] and my mother-in-law, who used to go to a particular homeopath, told us to visit him. He gave her a course of [medicines for] six months and she recovered,” says Gul.
Unfortunately with an autoimmune disorder, the odds of the condition propping up again are high. In Jada’s case, she revealed in 2018 that she had been struggling with the condition – and three years on, she shaved her head. For Gul’s child, there were no bald spots for two years. “But now again it’s started. I saw a bald patch on her head again. We went to the doctor again and she’s getting treated for that again,” she says. Dr Ajesh recommends early intervention when it comes to alopecia. “Parents should seek a doctor’s help immediately once you see alopecia in a child. This will help to diagnose the condition early and start immediate treatment,” she says.
“It has very disturbing for her [daughter] but she managed it very well. She never cried over it,” says Gul.
It can take a stab at a child’s sense of identity when their appearance suddenly changes. Getting used to the new normal may take time, but with patience and time, they will bounce back, stronger than ever before.
Have a topic you'd like us to cover? Write to us at parenting@gulfnews.com
