So we took him to our pediatrician and she told us she thought it could be 2 things. The first was trichotillimania, which is where people twirl or pull their hair so much that it creates bald spots. This was definitely something I thought it could be because Tyler has done this since he was a baby. He used to twirl my hair when he was nursing and has always twirled his for comfort when he's watching tv or before he falls asleep. The problem though, is usually you see a lot of broken hairs in the bald area and with Tyler, the area was completely smooth at the time.
So the other option was that it was a condition called alopecia areata, which is an autoimmune disorder where the bodies white blood cells mistakenly attack the hair follicles and make the hair fall out. It does not mean permanent hair loss and no one really knows why it happens, but in extreme cases, some people can lose all of their hair from this. She personally thought it could be this and sent us to a pediatric dermatologist who specializes in it and could help us treat it.
After meeting with him, he thought it was alopecia areata as well. We could have done a biopsy to be sure, but since Ty is only 2 we decided against it for now. They would have had to numb the area with a shot and then pull out a hair cell to examine and then stitch it back up with a few stitches. Sounds like a traumatic experience for a 2 year old, who is already nervous around doctors.
The treatments for alopecia are to have steroid injections into the spots to help the hair come out of the dormant stage it's in or to use steroid creams, and even those don't always work. After talking with him we decided to just wait a few months to see what happens naturally. Sometimes the hair just grows back all on it's own, which is what I am hoping for. I can see the hair follicles in the spot now, but they are not growing and if they do grow back it will happen very slowly.
I've never even heard of this condition before, but the derm said it was fairly common and he see's at least a patient a week about it. Everyone's case is different though so it's hard to compare if it will just happen this once or if it will be a lifelong battle. The right front side of Ty's hair is starting to thin a bit now too and I'm just hoping a patch isn't forming there, but we'll just have to see.
One good thing is that Tyler loves wearing hats lately, which is surprising to us because that is SO against his personality. He is usually a pretty stubborn kid and wants nothing to do with anything we want him to do! So that helps a bit when we are out and about and luckily his hair is longer so we can cover it up for now. We'll go back in a few months to see if it's gotten worse, better or stayed the same.
Luckily a 2 year old boy doesn't care about his hair at all... it's just been really hard on his mommy :(