Q. My daughter, who is eight years old, had a fall in school last year, resulting in a bump on her head.
The swelling has subsided, but the area where the bump was is now bald. Is there any help for the hair to regrow?
Occasionally, she complains of having a headache. Is that caused by the fall?
She has gone for an X-ray and everything is normal.
A. From the history, the hair loss seems to be traumatic in nature.
It is important to ascertain if there is scarring alopecia, which results in hair follicles being replaced by scar tissue.
This is diagnosed by the absence of hair openings at the bald patch site.
If it is confirmed to be scarring alopecia, it is unlikely for hair regrowth to occur.
Treatment for scarring alopecia includes surgical options such as scalp reduction therapy.
The bald patch is cut off and the hair-bearing edges of the scalp are brought together. The aim is to reduce the size of the bald patch.
If the bald patch is large, the procedure may have to be performed in multiple stages.
However, such surgery will result in a scar and the scar site will also be bald.
Another option is hair transplant, where hair can be transplanted to the bald patch.
The hair is usually from the patient's own scalp and can be harvested in a variety of methods.
You can also camouflage the bald patch with the use of wigs.
Some causes of hair loss, for example, alopecia areata, may show up as a bald patch and this condition is reversible.
It would be advisable for your daughter to be assessed by a dermatologist to determine the type of hair loss, so that appropriate advice and treatment can be given.
It is quite common for patients who have had minor head trauma to subsequently complain of physical symptoms such as headaches, dizziness or light-headedness.
This is part of the constellation of symptoms of post-concussion syndrome.
Difficulty of concentration, poor memory and mood changes are also sometimes noted after head trauma.
Over time, patients should progressively get better, although some patients do complain that these symptoms last for months or even a year.
Unfortunately, there is no medication to treat the root cause and most drugs are really symptomatic treatment for the physical symptoms.
The behavioural and emotional symptoms are more difficult to treat and a patient with such symptoms may need to be referred to a psychiatrist.
DR RAYMOND KWAH
Consultant dermatologist at Raffles Skin & Aesthetics Centre at Raffles Hospital
DR DAVID CHOY
Consultant neurosurgeon at Raffles Surgery Centre at Raffles Hospital
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