Causes Of Hair Loss In Children

Various factors can cause hair loss in children. Some factors can be addressed without any medical intervention, while some require immediate attention from a physician. The causes of hair loss in children are categorized into two groups:

1. Non-Medical Causes Of Hair Loss In Children

Newborn hair loss, friction, use of chemicals, blow drying, and tight hairstyles are some of the common non-medical causes of hair loss in children. (a) Newborn Hair Loss: Some newborn babies lose hair during the first six months of their birth to make way for new hair growth. This is absolutely normal and nothing to be alarmed about. (b) Friction: Rubbing their head against rough surfaces, such as mattresses, carpets, and floors, can cause children to lose hair. Once they get rid of this behavior, their hair will start to regrow. (c) Use Of Chemicals: The use of harsh chemicals for hairstyling processes, such as bleaching, dyeing, perming, or straightening, on children will damage their hair and cause it to fall out (3). Either avoid these processes altogether or switch to chemical-free and natural products. (d) Blow Drying: Exposing your child’s hair to excess heat while blow drying, perming, or straightening it will cause their hair to fall out due to heat damage. Instead, you can blow dry their hair on the lowest heat setting and restrict the frequency of other heat styling processes. (e) Tight Hairstyles: Pulling your child’s hair back with a comb or a hairbrush to tie it in tight ponytails, buns, or braids will harm their hair follicles and result in hair loss. You need to be gentle while detangling the hair and tie it in loose hairstyles to prevent hair loss.

2. Medical Causes Of Hair Loss In Children

Infections, diseases, or deficiencies, such as tinea capitis, alopecia areata, trichotillomania, telogen effluvium, hypothyroidism, and nutritional deficiencies, are some of the most common medical causes of hair loss in children (4). (a) Tinea Capitis: Tinea capitis, also known as the ringworm of the scalp, is a scalp infection caused by fungi called dermatophytes. Overcrowding and poor hygiene can aggravate the infection as it spreads easily through physical contact and sharing of combs and other objects of personal hygiene. Patchy hair loss, black spots in the areas of hair loss, itching, redness, bumps on the scalp, brittle hair, swollen lymph glands, and low-grade fever are the symptoms of tinea capitis (5). Dermatologists diagnose this infection with KOH microscopy and Wood’s lamp examination (6). In simple terms, the physician examines your child’s scalp and sends a piece of the infected skin to a lab for diagnosis. The affected child needs to take the prescribed antifungal drug for about eight weeks. Along with oral medication, using an antifungal shampoo prevents the spread of this infection. (b) Alopecia: Alopecia areata is an autoimmune disease in which the immune system harms the cells in the hair follicles and causes the hair to fall out in patches (8). Depending on the pattern of hair loss, alopecia is classified into three types: After examining the medical history of the child for cutaneous and systemic autoimmune diseases, physicians diagnose this disease by taking some hair from the child’s scalp and sending it for examination to a lab (9). There is no cure for alopecia areata. However, treatments involving the use of certain drugs, such as anthralin and minoxidil, or corticosteroid creams can suppress the symptoms , but does not help in the regrowth of hair (8), (9). These therapies may cause side effects. For those individuals wanting a more natural course of treatment may choose to use essential oils. With the right kind of treatment, children can regrow their hair within a year. (c) Trichotillomania: Trichotillomania is a form of obsessive-compulsive disorder characterized by an individual pulling out their hair out of a sense of compulsion. They do it on purpose, and some may even eat the hair they pull out. Patchy hair loss and broken hairs of varying lengths are some effects of trichotillomania (11). The hair can grow back once the child stops pulling it out. Physicians usually diagnose this condition using a dermoscope. The process is called dermoscopy. The hair usually grows back once the child stops pulling it out. Besides consulting a dermatologist, you need to consult a psychologist as well. Cognitive Behavioral Therapy (CBT) aids in teaching your child to be more aware of pulling their hair and helps them understand the emotions that trigger such behavior, eventually prompting them to stop it (12). (d) Telogen Effluvium: Telogen is the resting phase in a normal hair growth cycle. In this phase, the hair stops growing and rests so that the old hairs fall out and make way for new ones. Telogen effluvium is a condition in which the hair is pushed into the telogen phase (or the resting phase) prematurely, resulting in temporary hair loss. It can happen due to a stressful, shocking, or traumatic event. Children with this condition lose 300 hairs a day, unlike the average 100 hairs a day (13). Microscopic examination of the shed hair, CBC, serum iron, serum zinc, low vitamin D and thyroid function tests are some of the ways to diagnose this condition. This condition does not require any medical treatment in particular. Once the child is out of the stress or trauma, the hair grows back. It may take around six months to a year for the hair to grow back. (e) Hypothyroidism: The thyroid gland in the neck releases two main hormones, T3 and T4, to control the body’s metabolism. Inefficiencies in the production of these hormones, i.e., an underproduction or overproduction, affects the body’s metabolism (14). The underproduction of thyroid hormones results in a condition called hypothyroidism. Fatigue, weight gain, joint and muscle pain, constipation, dry skin, and thin and brittle hair are some of the symptoms of hypothyroidism. The thyroid function test can help diagnose this condition. It can be treated by oral medication and intake of iodine along with nutritious foods. Once your child starts the treatment, the hair fall stops gradually. It may take a few months for the hair to regrow. (f) Nutritional Deficiencies: Poor eating habits, resulting in the deficiency of vitamins, minerals, and protein, can cause your child’s hair to fall out (4). Psychological eating disorders, like anorexia and bulimia, can also cause hair loss. Surplus of vitamin A or deficiency of iron or vitamin D  zinc, niacin, biotin, protein, or amino acids also leads to hair loss (15). Blood tests, urine tests, and other medical tests help in the diagnosis of nutritional deficiencies. A healthy diet plan and nutritional supplements can assist in correcting the deficiencies, thereby aiding the regrowth of your child’s hair. (g) Chemotherapy: If your child is undergoing chemotherapy, a strong treatment to fight off cancer, they run the risk of losing their hair (16). This is because chemotherapy stops the quick division of cells (including the cells in hair follicles) to prevent the spread of cancer (5). However, hair fall stops, and the hair regrows once your child is done with the treatment.

How Common is Hair Loss In Babies And Children?

Hair loss is common in children, just like in adults. However, the causes can be different. Note that it’s normal to lose about 100 strands of hair in a day. You can perform a tug test to check if your child has hair loss issues. Gently pull a small section of your child’s hair. If more than 10% of hair falls out, it is a sign of hair loss. But don’t worry. In most cases, hair loss is reversible. The best way to treat hair loss is to consult a trichologist or pediatrician.

Should You See A Doctor?

You should see a doctor when you notice hair loss in your child. They will diagnose the cause of the hair loss, and recommend specific treatment. To diagnose the issues, the doctor may ask you questions about your child’s and your medical history. They may also suggest some lab tests. In most cases, hair loss is irreversible, but there may be a few medical conditions when it is permanent. Hair loss can be traumatic for a child. And that is why you must talk to them and explain the situation.

How To Talk To Your Child About Hair Loss

Hair loss can be tough to deal with, especially for a child. It can have a psychological impact on them. You may notice that your child is more stressed (which can cause more hair loss) or less social. The key to talking to your kid about their hair loss is to create a safe space for them. Let them know why they have hair loss and the possible treatments to regrow hair. You may want to talk to your child’s pediatrician and seek help from a therapist to help them. If the hair loss is irreversible, consider alternatives like wigs, hair extensions, scarves, or hats. You can also try changing your child’s hairstyle to cover the bald spots. Speak to a professional hair stylist for cues on changing your child’s hairstyle. You can use hair filler products to make the hair look fuller. However, consult a doctor before using any product on your child’s scalp or if you are considering a hair transplant. How do I know if my child has alopecia? Alopecia areata usually presents itself as one or several bald patches on the scalp that show no redness or scaling. Which vegetables are good for hair growth? Spinach, carrots, onion, sweet potatoes, tomato, beetroot, and French beans are some vegetables that are good for hair growth due to the presence of beta-carotene, vitamin A, antioxidants, and other nutrients. Does vitamin D affect hair? Yes. Vitamin D deficiency is linked to alopecia (15). It also plays a role in stimulating hair growth. However, do not take vitamin D supplements without consulting the doctor. How to fix hair loss due to eczema in toddlers? Eczema makes the scalp itchy, and aggressive scratching can lead to hair loss. Consult the doctor and use medicated shampoos, OTC products, and oral or topical steroids to reduce scalp inflammation. Is it normal for my two-year-old’s hair to fall out? Temporary hair loss is not uncommon in children and toddlers. However, consult a doctor if you notice excessive hair loss and bald patches.