Consult this chart if your child has any problems affecting the hair, scalp, fingernails, or toenails. In general, eating a well-balanced diet will help keep your child's hair and nails strong and healthy. Use a soft hairbrush on a young child's hair because it can be easily damaged. If your child's hair is long, avoid braiding it tightly or using uncovered rubber bands to tie it back. In children, the most common hair problems needing treatment are fungal infections and head lice.
Possible cause Ringworm, a fungal infection, may cause bald patches when it affects the scalp. Consult your doctor.
Action If your doctor confirms the diagnosis, your child will probably be prescribed a course of antifungal drugs. Once the infection has cleared up, the hair should grow back.
15
Possible cause and action Most baby hair is lost during the first year of life and gradually replaced by thicker hair. Rubbing on bedclothes or a baby seat can cause the loss of this delicate first hair to be marked in some areas.
16
Possible cause Alopecia areata, a condition in which the body's immune system attacks the hair follicles, is a possibility. Consult your doctor.
Action In children, the condition usually gets better without treatment. New hair should grow over the next 6-9 months. If the condition does not improve, your doctor may treat it with corticosteroid creams.
17
Possible cause and action Most baby hair is lost during the first year, usually resulting in a noticeable thinning of the hair for a brief period. Over the next few months, new, stronger hair will grow in its place. In some cases, the new hair may be a different colour from the baby hair.
18
Possible cause and action Certain drugs, particularly those used to treat cancer, can cause hair loss as a side effect. Consult your doctor. Meanwhile, your child should not stop taking any prescribed drugs. Hair growth often returns to normal when the drugs are stopped or treatment finishes. Hair loss due to cancer treatment will regrow, although it may be fine and downy at first. Your child should wear a hat when outdoors to protect the scalp from sunburn.
19
Possible cause A long illness or an operation can disrupt the normal hair growth cycle (seeHair structure and function), resulting in many hairs being lost at the same time. Consult your doctor.
Action Your doctor will check your child's general health. As long as your child is now in good health, the hair growth cycle should return to normal within 6 months.
20
Possible causes Your child probably has dandruff, which is a form of seborrhoeic dermatitis often associated with a fungal scalp infection. However, a flaking scalp may also be due to other conditions, such as psoriasis.
Action An over-the-counter dandruff shampoo or a shampoo containing ketoconazole should clear up the condition. If your child's scalp is no better within 4 weeks, consult your doctor.
21
Possible cause An infestation of head lice is possible. Lice are transmitted by close contact. Comb your child's hair over a sheet of white paper using a fine-toothed comb to confirm that lice are present. These tiny black insects are less than 2 mm ( 1/16 in) long. Their white eggs (nits) can sometimes be seen attached to hair shafts.
Action Head lice can be treated with preparations available from your pharmacist ( Treating head lice).
22
Possible cause An ingrowing toenail is the most likely cause of these symptoms.
Possible cause Acute paronychia, a bacterial infection of the skin adjacent to a nail, may be the cause. Consult your doctor.
Action Your doctor may prescribe antibiotics as a cream or as tablets. If pus has formed, it may need to be drained under local anaesthetic.
24
Possible cause and action A fungal infection around the nail may be the cause. Consult your doctor, who may prescribe an antifungal cream. Keep your child's hands out of water as much as possible until the condition clears up.
25
Possible cause Nail-biting may be copied from other children or it may arise as a nervous habit (seeHabitual behaviour). Nail-biting is common in children and is not a risk to health. However, bitten nails may feel sore or look unsightly. In rare cases, broken skin on the finger tips may become infected by bacteria from the mouth.
Action Try to keep your child's nails trimmed and smooth. Draw your child's attention to the habit when you see him or her doing it, but try not to nag because this may make the habit worse. Over-the-counter preparations that can be painted on the nails to make them taste unpleasant may be worth trying. Consult your doctor if the skin around the nails becomes red or inflamed because an infection may have developed.
26
Consult your doctor if you are unable to make a diagnosis from this chart.
27
Consult your doctor if you are unable to make a diagnosis from this chart.
Looking after your child's hair and nails
To keep your child's hair looking clean and healthy, wash it about twice a week. If your child hates having his or her hair washed, try using a shampoo shield that fits over the head or a non-sting shampoo. Rinse the hair thoroughly to remove all the suds, and comb the hair through gently while it is still damp. Allow it to dry naturally, if possible.
Keep your child's nails short to prevent accidental scratching of him- or herself. Short nails are also easier to keep clean. Use blunt-ended scissors, and trim the fingernails in the shape of the finger tip and the toenails in a line straight across the toe.
Self-Help Treating head lice
Removing lice and eggs Carefully combing through your child's hair with a fine-toothed nit comb will remove eggs and dead lice.
Contrary to popular belief, head lice prefer clean, not dirty, hair. Head lice can be treated with an over-the-counter lotion or shampoo. Follow the directions on the packet, and then remove the dead lice and their eggs, known as nits, by combing through the hair with a fine-toothed nit comb. Alternatively, try coating the hair in conditioner and combing it through with a nit comb daily, or try using a battery-operated comb that electrocutes the lice. Whichever method you use, treat everyone in the household and wash all combs and towels in hot water to prevent reinfestations.
Family Doctor Health Advisor is for information purposes only, and is designed as a general reference and catalyst to seeking further information.
The RACGP is not engaged in providing medical or other advice or services, and is not responsible for the results of any actions taken by any person on the basis of any information in this publication, or for any error in, or omission from, this publication.
Publication Date: 31 March 2009 Authorised By: RACGP
