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Check up: My daughter has a bald patch

I WAS brushing my daughter's hair the other day when suddenly I noticed that she has a small, round bald patch. She has long hair so it's not particularly noticeable but I am worried that it might spread. Is there a way to get her hair to grow back?

I CAN understand your concern. Of all the non-serious complaints that send patients scuttling to the doctor, alopecia is probably one of the most common.

Generally, the condition exists for some time before it is noticed. It is the limited, often circular patch that is noticed first, rather than the baldness that consists of a gradual thinning all over the head.

Alopecia in children needs an expert to diagnose it, because these small bald patches can be a sign of a ringworm infection. The doctor can recognise this by the fact that the patches tend to be scaly, with a number of short broken hairs with frayed ends.

Anaemia, fungal infections, stress and thyroid problems can also contribute to hair loss.

Some children also get into the habit of pulling or twisting their hair in one particular area and this can give rise to what is called traumatic alopecia.

However, sometimes alopecia can occur for no apparent reason. It is not contagious and it can occur in parts of the body other than the scalp -- in the armpits, around the scrotum or in the eyebrows.

It also has an infuriating habit of turning up in several places at once. Very occasionally, it can spread over a large area of the scalp.

Patients are naturally rather alarmed as soon as a round patch of baldness is found.

Like you, they want to know if there is any treatment and if it will spread. These are the usual questions, but sadly the answers are not easy.

Fortunately, in the great majority of cases the doctor can safely prescribe patience since the hair will often begin to grow again. There may be a snag, however, for the hair may return a different colour.There are other treatments available though, so ask your GP for advice. Some patients find that lotions or steroid injections and creams help to encourage hair growth, although they aren't suitable for everyone.

In the meantime, make sure your daughter has as normal a diet as possible and is spared any unnecessary stress or anxiety.