Is your little one losing hair? If you are having a hard time figuring out the cause, this article is for you. Many studies have proven that there is a link between hair and self-image, psychosocial functioning, emotional well-being, and quality of life (1), (2). Hair loss at a tender age can have a significant impact on a child’s psychology. Before you talk to your child about feeling confident from within and find an appropriate solution for this problem, let us understand the causes of hair loss in children.
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:
- Non-medical causes
- Medical causes
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 (7). Depending on the pattern of hair loss, alopecia is classified into three types:
- Alopecia areata – The hair on some parts of the scalp falls out, forming bald patches on the head.
- Alopecia totalis – All the hair on the scalp falls out.
- Alopecia universalis – All the hair on the entire body falls out.
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 (8).
There is no cure for alopecia areata. However, treatments involving the use of certain drugs, such as anthralin and minoxidil, or corticosteroid creams can help in the regrowth of hair (7), (8). 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 (9). 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 (9).
(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 (10).
Microscopic examination of the shed hair, CBC, serum iron, serum zinc, 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 (11). 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, zinc, niacin, biotin, protein, or amino acids also leads to hair loss (12).
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 (13). 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.
Losing hair can be a disturbing experience for your child and result in low confidence and self-esteem. Identifying the cause of their hair loss is the first step towards treating it effectively. Work with your child’s healthcare provider to zero in on the best solution to make them look and feel better.
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- Treating Female Pattern Hair Loss, Harvard Medical School, Harvard Health Publishing.
- Hair Cosmetics: An Overview, International Journal of Trichology, US National Library Of Medicine, National Institutes of Health.
- Hair Loss in Children: Common and Uncommon Causes; Clinical and Epidemiological Study in Jordan, International Journal of Trichology, US National Library Of Medicine, National Institutes of Health.
- Management Of Tinea Capitis In Childhood, Clinical, Cosmetic and Investigational Dermatology, US National Library Of Medicine, National Institutes Of Health.
- Common Tinea Infections in Children, American Family Physician, US National Library Of Medicine, National Institutes Of Health.
- Alopecia Areata, Nature Reviews Disease Primers, US National Library Of Medicine, National Institutes Of Health.
- Current Treatment Strategies In Pediatric Alopecia Areata, Indian Journal Of Dermatology, US National Library Of Medicine, National Institutes Of Health.
- Pediatric Trichotillomania, Current Psychiatric Reports, US National Library Of Medicine, National Institutes Of Health.
- A Practical Approach to the Diagnosis and Management of Hair Loss in Children and Adolescents, Frontiers In Medicine, US National Library Of Medicine, National Institutes Of Health.
- A Descriptive Study of Alopecia Patterns and their Relation to Thyroid Dysfunction, International Journal of Trichology, US National Library Of Medicine, National Institutes Of Health.
- The Role of Vitamins and Minerals in Hair Loss: A Review, Dermatology And Therapy, US National Library Of Medicine, National Institutes Of Health.
- Chemotherapy-Related Hair Loss (Alopecia) in Children, University of Rochester Medical Center.
- Hair Loss And Cancer Treatment, National Cancer Institute.