Gray hair in children

Can a child have gray hair? Yes, they can.

Why do they appear and what does it mean? This means that the hair follicles have a reduced level or are completely lacking the pigment melanin, which colors the hair.

There is also a medical term called "poliosis," which refers to patches of discolored hair along the hairline in the forehead, eyebrows, and/or eyelashes, as well as patches of gray hair elsewhere on the scalp. Poliosis can even occur in newborns.

Reasons why a child has gray hair

The causes of such a symptom as gray hair in a child are focal or diffuse hypopigmentation (depigmentation) of hair or hypomelanosis.

This condition may be caused by:

• vitiligo; [ 1 ]
• albinism in children or piebaldism (incomplete albinism); [ 2 ]
• hypomelanosis of Ito - a rare neurodermatological disease associated with X-chromosomal abnormalities that manifest as skeletal deformities, ophthalmological abnormalities (nystagmus, strabismus, cataracts) and CNS abnormalities (intellectual and motor retardation); [ 3 ]
• Recklinghausen's disease or hereditary neurofibromatosis type I; [ 4 ], [ 5 ]
• tuberous sclerosis - a genetic disorder with an autosomal dominant inheritance pattern in which a child is born with a strand of gray hair and hypopigmented spots on the skin; [ 6 ]
• Chediak-Higashi syndrome (Chediac-Higashi); [ 7 ]
• Vogt-Koyanagi syndrome (or Vogt-Koyanagi-Harada disease) with inflammation of the iris and choroid, hearing problems and pronounced neurological symptoms; [ 8 ]
• Griscelli syndrome, which is associated with inherited gene mutations and has three forms and various non-pigmentary, neurological and immune symptoms; [ 9 ]
• Graves' disease or hyperthyroidism in children, [ 10 ] as well as Hashimoto's disease or autoimmune thyroiditis.

In Waardenburg syndrome, gray hair in a newborn child (along the forehead) is not the only sign of pathology, and children may have heterochromia of the iris (eyes of different colors); hypertelorism (wide bridge of the nose) and synophrysis (fused eyebrows); neurosensory hearing loss, seizures, tumors. The prevalence of this syndrome in the population is estimated at one case per 42-50 thousand people, and in schools for the deaf, according to some data, one child out of 30 has Waardenburg syndrome. [ 11 ] Moreover, if a newborn is diagnosed with intestinal obstruction or constipation from birth (congenital aganglionosis of the colon or Hirschsprung's disease), then Waardenburg-Shach syndrome is diagnosed. [ 12 ] And when combined with hypoplasia of the limb muscles and joint contractures – Klein-Waardenburg syndrome. [ 13 ]

Risk factors

Among the risk factors for disruption of melanin synthesis, experts note:

• insufficiency and/or protein-energy malnutrition;
• deficiency of cyanocobalamin – vitamin B12 – with the development of pernicious anemia (quite common in vegans), as well as deficiency of this vitamin and folic acid (vitamin B9) during pregnancy in the mother, leading to megaloblastic anemia in the child;
• copper deficiency in the body;
• thyroid problems;
• adrenal insufficiency;
• chronic exposure of the body to heavy metals (lead).

Pathogenesis

Melanin-producing cells, melanocytes, are formed from the cells of the neuroectoderm of the neural crest of the embryo (melanoblasts), which spread into tissues and are subsequently transformed. Melanocytes are present not only in the skin and hair follicles, but also in other tissues of the body (in the membrane of the brain and in the heart, in the choroid of the eye and the inner ear).

The production of hair shaft melanin (follicular melanogenesis) by oxidation of L-tyrosine does not occur continuously, as in the epidermis, but cyclically - depending on the phase of hair growth. At the beginning of anagen, melanocytes multiply, mature by the end of this stage, and then - during the catagen period - undergo apoptosis (die). And this entire process depends on a number of factors and is regulated by many enzymes, structural and regulatory proteins, etc.

The production of melanin and its transfer from melanocytes to keratinocytes of hair follicles depend not only on the presence of its precursors (5,6-dihydroxyindoles, L-dopaquinone, DOPA-chromium), but also on many auto- and endocrine factors. Researchers have concluded that follicle melanocytes – compared to skin melanocytes – are more sensitive to the effects of peroxides and free radicals, i.e., they are more easily damaged by oxidative stress.

Thus, minimal or no melanin formation in all forms of albinism is caused by mutations in the tyrosinase gene (TYR), a copper-containing enzyme that catalyzes the synthesis of melanin from the amino acid tyrosine. As well as mutations in the genes of the TYRP1 and TYRP2 enzymes, which are important participants in melanogenesis, regulating the activity of tyrosinase, the proliferation of melanocytes, and the stability of the structure of their melanosomes.

In tuberous sclerosis (which occurs in one child out of 6 thousand children), the pathogenesis is associated with hereditary or sporadic mutation of the genes of the hamartin and tuberin proteins (TSC1 and TSC2), which regulate the growth and proliferation of cells (including melanocytes).

Vogt-Koyanagi multisystem syndrome is thought to result from an abnormal autoimmune reaction to melanin-containing cells in any tissue of the body.

And in such an organ disease as Waardenburg syndrome, the mechanism of development of the pathological condition is rooted in mutations of the EDN3, EDNRB, MITF, PAX3, SNAI2 and SOX10 genes, which are directly related to the formation of melanocytes.

Read also: Anatomical and physiological features of the skin and its appendages.

Consequences and complications

Gray hair in children by itself cannot cause complications or negative health consequences.

However, the appearance of such a symptom as bleached hair in a child may be combined with other signs of certain diseases and pathological conditions (listed above), which pose a serious risk.

Diagnostics

To determine the cause of hair depigmentation, a complete medical history (including family history) is required.

A general blood test and thyroid hormone tests are taken.

An examination of the skin area with depigmented hair is carried out using a Wood's lamp, as well as by dermatoscopy.

Based on the assessment and comparison of all clinical signs, differential diagnosis is carried out.

What to do, treatment

If PUVA therapy is used in the treatment of vitiligo, then Ito's hypomelanosis is treated with glucocorticosteroid injections, since there are simply no etiotropic agents for the treatment of this type of pathology or albinism.

In case of syndromes with ophthalmological or neurological lesions, appropriate symptomatic means are used. But what to do in case of melanin synthesis disorder?

If a vitamin B12 deficiency is detected, vitamin supplements are prescribed. In case of copper deficiency, it is recommended to introduce whole grain products, legumes, beef liver, sea fish, eggs, tomatoes, bananas, apricots, walnuts, sunflower and pumpkin seeds into the child’s diet.

Doctors also recommend taking ginkgo biloba preparations for two to three months, which are said to promote repigmentation.

You can use a hair tonic consisting of carrot juice, sesame oil and fenugreek seed powder; make hair masks from aloe vera gel (which contains antioxidants, vitamins B12 and B9, zinc and copper).

Prevention

Specific methods for regulating melanogenesis have not yet been found, therefore there are no measures to prevent congenital pathologies of melanin synthesis in hair follicles.

Although researchers claim that antioxidants, vitamins A, C and E, as well as biologically active compounds found in dark greens, berries and fruits, and brightly colored vegetables, help increase melanin synthesis.

Forecast

Most likely, a child's gray hair will be his "mark" for life: this is the medical prognosis regarding genetically determined focal or diffuse pigmentation disorders and orphan syndromes.