Hair loss in 15yo

[sassenach]

DD has been dealing with massive amounts of hair loss for a few weeks now. She has thick, beautiful hair and she now is starting to develop some small bald spots. Her Dr diagnosed her with telogen effluvium, but that was before bald spots started to emerge. Her blood panels are all normal- not anemic, Vit D is on the low end of normal (I have her started on supplements), her T3 and TSH were both 1.1.

I'd love input on supplements or anything else we can do to help. Her Dr suggested Rogaine but I'm a little concerned about skin reactions because this kid reacts to everything.

[J-rap]

Once I asked my dd's dermatologist if zinc supplements would help with acne (I'd read some articles that said it might), and she didn't seem to know much about that, but I do clearly remember her saying that zinc has been shown to help with hair loss like what you're describing.  You might want to look into that. 

[Arcadia]

I was thinking of Rogaine for alopecia due to chemotherapy. Below quoted put me off. I am using a leave in conditioner that contains castor oil instead.

https://www.webmd.com/drugs/2/drug-12570/rogaine-topical/details

“It takes time for hair to regrow. Most people need to use this medication regularly for 4 months to see benefit. This medication must be used continuously to maintain hair growth. If your condition does not improve or worsens after using this medication for 4 to 6 months, or if you think you may have a serious medical problem, tell your doctor”

[GoodGrief]

Do you feel confident that it is not hairpulling? One of mine struggled with trichotillomania around that age with small bald spots. Is it more generalized hair loss?

[Pen]

In addition to D and zinc, look into B vitamins, C, iron (too much = bad, but too little is associated with hair loss), oils, fatty acids, magnesium...

[Liz CA]

Imbalance of estrogen, progesterone and testosterone levels?

[Violet Crown]

Fungus? Wee Girl had bald spots misdiagnosed because of her other issues, but it turned out to be totally unrelated and was quickly fixed with medicated shampoo.

[Beth S]

Our dd had this during her 1st year of Nursing School.
In hindsight, she was stressed out and had lost weight.
Our derm asked all kinds of personal questions, to see if there was an emotional cause.
(Regardless, it takes a while to recover from.)

Edited June 20, 2020 by Beth S

[ktgrok]

Is she getting enough protein? After bariatric surgery everyone thinks hair loss is from this that or the other, but the number one factor is not enough protein. 

[HS Mom in NC]

Was the Dr. a GP or a dermatologist? Don't take advice abut this from a GP, they're not qualified to diagnose it. See a specialist.

My bio daughters have alopecia areata. It can came and go. It's autoimmune in nature and there aren't many treatment options.

Low B12 long term is a very big deal. If it's due to low B12, it could be because she's lost the ability to absorb it in her digestive system.  BTDT.  If that's the case, supplements are not going to be effective, she'll need shots. Mine was scary low and required about a dozen shots over almost a month to get me back up to normal and an injection every 1-2 weeks to maintain. Med spas do it as a walk in appointment for cheap, some pharmacies do it, and she can learn to do it herself.  You need a blood test however you treat it (shots or supplements) to confirm that they're working and that you're back up to normal. 

[NorthwestMom]

2 hours ago, Beth S said:

Our dd had this during her 1st year of Nursing School.
In hindsight, she was stressed out and had lost weight.
Our derm asked all kinds of personal questions, to see if there was an emotional cause.
(Regardless, it takes a while to recover from.)

 I agree, you can get hair loss for stress.  It takes about 3 months to manifest after the stressor event (it affects the hair growth cycle). My DD lost a lot of hair 3 months after being very ill with pneumonia and the dermatologist diagnosed it as this. After a short time the loss reduced and has not recurred. 

I recommend taking your DD to a dermatologist, if the doctor she saw is from a different specialty.

[ktgrok]

4 minutes ago, NorthwestMom said:

 I agree, you can get hair loss for stress.  It takes about 3 months to manifest after the stressor event (it affects the hair growth cycle). My DD lost a lot of hair 3 months after being very ill with pneumonia and the dermatologist diagnosed it as this. After a short time the loss reduced and has not recurred. 

I recommend taking your DD to a dermatologist, if the doctor she saw is from a different specialty.

Yes - it does happen about 3 months or 4 months later, and then lasts for several months. Surgery, illness, etc can cause it. 

[sassenach]

9 hours ago, GoodGrief1 said:

Do you feel confident that it is not hairpulling? One of mine struggled with trichotillomania around that age with small bald spots. Is it more generalized hair loss?

1000% confident. It's generalized hair loss that now seems to be producing spots. It's falling off of her before my eyes all day long.

[sassenach]

5 hours ago, Beth S said:

Our dd had this during her 1st year of Nursing School.
In hindsight, she was stressed out and had lost weight.
Our derm asked all kinds of personal questions, to see if there was an emotional cause.
(Regardless, it takes a while to recover from.)

 

3 hours ago, NorthwestMom said:

 I agree, you can get hair loss for stress.  It takes about 3 months to manifest after the stressor event (it affects the hair growth cycle). My DD lost a lot of hair 3 months after being very ill with pneumonia and the dermatologist diagnosed it as this. After a short time the loss reduced and has not recurred. 

I recommend taking your DD to a dermatologist, if the doctor she saw is from a different specialty.

 

3 hours ago, Ktgrok said:

Yes - it does happen about 3 months or 4 months later, and then lasts for several months. Surgery, illness, etc can cause it. 

If we count back 3 months, we're at the start of shelter in place, so yes, we have been thinking that if this is stress-triggered telogen effluvium, then that's the inciting event.

[sassenach]

4 hours ago, Ktgrok said:

Is she getting enough protein? After bariatric surgery everyone thinks hair loss is from this that or the other, but the number one factor is not enough protein. 

I think so. She's not great about vegetables but she's pretty good about protein. 

[sassenach]

3 hours ago, Homeschool Mom in AZ said:

Was the Dr. a GP or a dermatologist? Don't take advice abut this from a GP, they're not qualified to diagnose it. See a specialist.

My bio daughters have alopecia areata. It can came and go. It's autoimmune in nature and there aren't many treatment options.

Low B12 long term is a very big deal. If it's due to low B12, it could be because she's lost the ability to absorb it in her digestive system.  BTDT.  If that's the case, supplements are not going to be effective, she'll need shots. Mine was scary low and required about a dozen shots over almost a month to get me back up to normal and an injection every 1-2 weeks to maintain. Med spas do it as a walk in appointment for cheap, some pharmacies do it, and she can learn to do it herself.  You need a blood test however you treat it (shots or supplements) to confirm that they're working and that you're back up to normal. 

GP. And she didn't check B12. 

[HS Mom in NC]

57 minutes ago, sassenach said:

GP. And she didn't check B12. 

Oops.  That was Pen's post about B vitamins.

See a dermatologist. If it's not a run of the mill cold, flu or something minor, see s specialist.  You can lose all kinds of time with a GP farting around with guesses they're not qualified to make, or you can just go see an expert who is qualified.

My hair was shedding very badly due to the B12 deficiency. After it was under control it filled back in. 

Daughters each had different hair loss severity due the alopecia areata.  It grew back a couple of months later for daughter who lost an eyebrow (she was 13 at the time) and it took a  couple of years later for daughter who lost her all of her eyelashes,  eyebrows and the front half of the hair on her head.  (From where a headband would sit going from right behind the ears to the top her head and everything in front of that. She was 10 years old when it started. ) Thankfully hair scarves were on trend at the time and she's my detail oriented kid who very quickly learned to put fake eyelashes on like a professional. For years people had asked her if her natural eyelashes were fake because they were so long and thick, then when she was wearing fake ones they looked like her natural eyelashes.

[Pen]

It probably isn’t this, but I know someone who went completely bald due to a systemic fungus illness. 

 

[JennyD]

What a weird coincidence -- my DS15 has also been reporting hair loss and just yesterday he showed me his pillowcase, covered in what seemed like an unusual if maybe not alarming amount of hair.  He eats well, so I was wondering if perhaps it is stress.  

 

[Pen]

7 minutes ago, JennyD said:

What a weird coincidence -- my DS15 has also been reporting hair loss and just yesterday he showed me his pillowcase, covered in what seemed like an unusual if maybe not alarming amount of hair.  He eats well, so I was wondering if perhaps it is stress.  

 

 

There’s a lot currently due to stress—was in a headline I saw.

[TracyP]

5 hours ago, Homeschool Mom in AZ said:

Oops.  That was Pen's post about B vitamins.

See a dermatologist. If it's not a run of the mill cold, flu or something minor, see s specialist.  You can lose all kinds of time with a GP farting around with guesses they're not qualified to make, or you can just go see an expert who is qualified.

My hair was shedding very badly due to the B12 deficiency. After it was under control it filled back in. 

Daughters each had different hair loss severity due the alopecia areata.  It grew back a couple of months later for daughter who lost an eyebrow (she was 13 at the time) and it took a  couple of years later for daughter who lost her all of her eyelashes,  eyebrows and the front half of the hair on her head.  (From where a headband would sit going from right behind the ears to the top her head and everything in front of that. She was 10 years old when it started. ) Thankfully hair scarves were on trend at the time and she's my detail oriented kid who very quickly learned to put fake eyelashes on like a professional. For years people had asked her if her natural eyelashes were fake because they were so long and thick, then when she was wearing fake ones they looked like her natural eyelashes.

A slight derail because it does not sound like the OP's daughter has alopecia. (That usually presents with round bald patches at the beginning. I agree that a dermatologist is definitely the way to go to get a definitive answer.) I just wanted to say that my oldest has alopecia universalis so I get how traumatizing this disease is. She started losing her long, thick beautiful hair when she was 13 and it was all gone by the time she turned 15. She has gotten back her lashes and brows after a year on methotrexate. Her hair is also starting to grow in. Fingers crossed that it continues. She got away with scarves for a long time and now wears a beanie. She is almost 17 and very confident in herself but wow it's been a long road. I'm so glad your daughters recovered spontaneously!! Alopecia is an awful condition to deal with. I rarely "meet" anyone else who has walked this road so I wanted to throw that out there. 

[ktgrok]

If it is from stress, just know that due to the hair cycle, it will continue for a while, but that doesn't mean forever....it just takes a few months to stop totally. And it doesn't all fall out, just gets a bit thinner.

[Pen]

If it is from stress, vitamins, minerals may still be very important to look at  because they tend to get depleted during stress, some more than others.   Iron iirc would be more likely depleted from menstruation and not getting enough in diet.  Zinc and magnesium, B vitamins often used more during stress...

[sassenach]

3 hours ago, JennyD said:

What a weird coincidence -- my DS15 has also been reporting hair loss and just yesterday he showed me his pillowcase, covered in what seemed like an unusual if maybe not alarming amount of hair.  He eats well, so I was wondering if perhaps it is stress.  

 

 

3 hours ago, Pen said:

 

There’s a lot currently due to stress—was in a headline I saw.

Yes, my eldest was telling me that she saw an article about it. 
 

I also just remembered that dd15 was as sick as she’s ever been a few weeks before lock down. She’s the one that we thought may have had Covid. She hasn’t been tested but I had the same illness and was negative for antibodies, so probably not Covid but something really unpleasant. 

[Pen]

56 minutes ago, sassenach said:

 

Yes, my eldest was telling me that she saw an article about it. 
 

I also just remembered that dd15 was as sick as she’s ever been a few weeks before lock down. She’s the one that we thought may have had Covid. She hasn’t been tested but I had the same illness and was negative for antibodies, so probably not Covid but something really unpleasant. 

 

That could add to stress! And nutrient depletion too. 

 

So many people seem to have gotten very sick, but with  neg CV19 test results, it makes me wonder if there’s a second novel virus in circulation. 

 

[Kalmia]

Unlikely, but worth checking. You mentioned that protein was not a problem. Is she getting a lot of her protein from fish (tuna, sushi, etc.)? High mercury levels resulting through the excessive consumption of some fish have been found to result in hair loss. 

https://www.karger.com/Article/Fulltext/485749

[sassenach]

1 hour ago, Pen said:

 

That could add to stress! And nutrient depletion too. 

 

So many people seem to have gotten very sick, but with  neg CV19 test results, it makes me wonder if there’s a second novel virus in circulation. 

 

I kind of doubt it. I think we have these hard, flu-like viruses circulating every year but we're just used to it. I've shared here that last year my ds was hospitalized for 5 days with human metapnuemovirus. We only discovered exactly what it was because he's fragile enough to land in the hospital and they did a virus panel when his flu swabs were negative. I've heard of so many people who had a lot of the same symptoms and chocked it up to the flu (or in hindsight, Covid, which I think is incorrect).

[JennyD]

I talked at length today with my best friend, who is a child and adolescent psychiatrist.  She went through a checklist of symptoms and then concluded that it was almost certainly stress.  She gently reminded me that a few weeks ago DS had a tremendously stressful psychological experience.  I can't believe that I wasn't even thinking about that but I guess I've sort of pushed it away myself.  Anyway, we will keep an eye on the situation and see it if improves.  

 

[Ellie]

On 6/20/2020 at 2:03 PM, sassenach said:

DD has been dealing with massive amounts of hair loss for a few weeks now. She has thick, beautiful hair and she now is starting to develop some small bald spots. Her Dr diagnosed her with telogen effluvium, but that was before bald spots started to emerge. Her blood panels are all normal- not anemic, Vit D is on the low end of normal (I have her started on supplements), her T3 and TSH were both 1.1.

I'd love input on supplements or anything else we can do to help. Her Dr suggested Rogaine but I'm a little concerned about skin reactions because this kid reacts to everything.

I'm not concerned that her TSH was only 1.1 I am concerned that the T3 was only 1.1. That is hypothyroid range. Also, was that Free T3? And didn't the doctor test Free T4, as well?

Of course, the hair loss might not be thyroid-related at all, but as long as the doctor is checking everything, there needs to be the appropriate thyroid labs, which are Free T3, Free T4, and Reverse T3. Most doctors really don't treat thyroid issues properly, and so you may have problems getting the proper labs. You must persist.

Also, be sure to keep hard copies of all lab work. Hard copies. Of everything.

[CAtoVA]

DS had this issue start at age 15 last March of 2019. Took him to a dermatologist in June who did lots of blood work (all fine) and ended up diagnosing him with alopecia areata (a benign auto-immune disorder). She said it often runs in families but my DH and I have no family history of this.She thinks being very ill with winter bugs stressed his immune system and made it malfunction. She also said it is very common among children and adolescents and she sees two or more people a week with it. The doc said it usually resolves by itself in 1-2 years but we decided to try treatments. My DS started steroid shots in his scalp/head every 4 weeks (near the bald patches).

More hair kept falling out until about December 2019 (6 months of shots) when things started turning around. I  adjusted his vitamins adding in Biotin, Zinc and more B vitamins in general. We also did acupuncture once a week for 14 weeks starting in October 2019. Starting in Feb his hair began to to get gorgeously thick, wavy and filled in (was not as wavy or thick before this problem). He still has a few very small spots which are not readily visible due to his now quite thick hair. He stopped getting shots in February 2020. The doc said it could come back especially if he experiences stress but that the shots work for him so that is what he should do. It was a tough year for him as a teenage, self-conscious boy who had several bald spots out of the blue. I was proud of him that he still did most activities and went places, etc., and didn't let it stop him much from doing things. Sometimes he would wear a hat but usually not. The kids at co-op all thought he was having chemo and were kind to him so that helped..

[The Governess]

If your dd was very sick in February/March that could definitely be the cause. Same thing happened to my dd last year. She had the flu at the end of February and was very ill. Starting at the beginning of June or so, she started shedding a LOT of hair. It was super noticable and concerning. After a lot of research and examining her diet, etc. we guessed it was probably due to the virus. It lasted for a good month and then slowly started improving and the amount of shedding was back to normal within a month or two from when she first noticed it.