Tests to Run for 13 Year Old Girl Losing Hair

Dr. Rassman, my 13-year-old daughter (caucasian) has been experiencing thinning hair these past few months. Her dark wavy hair in the past had always been pretty thick. Her pediatrician ran anemia and thyroid tests which came back normal. We then saw a dermatologist who ran free testosterone and DHEAS–these too came back normal. The next step we are doing is seeing a endocrinologist (appt. not available until February). Are there some other tests that ought to be run in the interim, or should we see a hair specialist (do you know of any in the Metro Detroit area with a female (teenage) hair loss specialty?)

Her diet is fairly balanced, she has not experienced any stressful episodes, and she feels fine physically. I have recently been giving her Women’s 1-A Day vitamins since this problem has occurred. In the Spring of 2005, she began taking Cephalexin (Keflex) for acne. The dermatologist gradually reduced her intake, and she has recently stopped taking it entirely. Another note is we visit the Islands every February (during the past 7 years) whereby she has her hair braided. She would generally keep the braids in for a week, which looking back must have caused a lot of stress on her hair, but again, that would be 8 monts after the fact that the problem began. Thank you for any insight you may be able to provide.

-Very concerned parent

You daughter can go through periods of shedding hair and then reverse and regrow the hair. It is normal to lose up to 100 hairs per day. Now, if she continues to lose more than 100 hairs and she begins to show bald spots or more scalp, then it is a concern. There are many causes for hair loss in women as you outlined she is or has been evaluated for. The list includes: hypothyroidism, alopecia areata, telogen effluvium, androgenic alopecia, repeatedly over plucking, surgery, trichotillomania, stress, chemotherapy, radiation, cancer, eczema, seborrhea, scleroderma, lupus, hormonal imbalance, psoriasis, parasites, fungal, autoimmnune disorders, poor diet, poor nutrient, burn, trauma, leprosy and drugs. The common medications which may cause hair loss are beta-blocker, coumadin, oral contraceptive pill, antibiotics and chemo-medications. Braiding hair could cause permanent hair loss if it is kept for a long period of time and especially when a person has sensitive/weak hairs. I believe visiting a hair doctor in your area is a got start. A full analysis for miniaturization with a good microscopic evaluation of the scalp hair is critical in understanding the process. Continue with your present course and get the scalp mapped out as well.