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Alopecia in Children: How to Manage Hair Loss in Children

It can be distressing to find that your child’s hair is falling out. There are many possible causes of hair loss in children, and both medical and nonmedical causes can be to blame. Read on to learn about managing hair loss in kids, as well as general tips for keeping your child’s hair healthy.

Alopecia in children

How common is hair loss in children?

When you think of hair loss, you may think of older adults, but kids can lose their hair, too. Many conditions can cause hair loss in kids, and there are studies that have estimated the prevalence of some of these conditions. 

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Children don’t lose their hair often, but there are many conditions that can cause hair loss in children. One of the more common causes of hair loss in kids, alopecia areata, affects about 1 in 1,000 people. Another common cause of hair loss, trichotillomania, has been reported to affect anywhere between 0.6% and 3.4% of people, depending on the population studied. These conditions, and others that may cause hair loss in kids, are described in detail below.

Diagnosis of alopecia in children

Doctors may diagnose alopecia by asking children and their parents questions. They may also examine the scalp and hair or order laboratory tests. 

If your child has hair loss, their doctor may ask questions to help determine the cause. For example, a doctor may ask:

  • When did the hair loss start?
  • Is the scalp itchy or sore?
  • What hair care products are used?
  • Are other parts of the body affected?
  • Do other family members have hair loss?

The doctor may perform an examination of the head and scalp. During this examination, they may consider the pattern of hair loss, the thickness of the remaining hair, the appearance of the skin, and other factors. They may also perform what’s called a hair pull test. This simple test involves grasping about 50 strands of hair to see how many strands fall out easily.

Doctors may diagnose alopecia by asking children and their parents questions. They may also examine the scalp and hair or order laboratory tests.

Sometimes, doctors need to order laboratory tests to diagnose alopecia. The specific tests will vary based on the conditions they suspect are responsible for the hair loss, but scalp cultures, scalp biopsies, and blood tests are some possibilities.

Common causes of alopecia in children

Many medical conditions can cause hair loss in kids. Some of the more common causes include alopecia areata, tinea capitis, trichotillomania, and telogen effluvium. 

  • Alopecia areata often causes one or more round, bald patches where hair used to be. The scalp is the most commonly affected area, but hair loss can occur on the eyebrows, eyelashes, and other areas, too. With complete alopecia, affected areas usually have the appearance of skin, without scaling, scarring, erythema or atrophy. Empty follicles can still be seen on the involved scalp. Eventually, some people with this condition can go bald or even lose all of their body hair.
  • Tinea capitis is a fungal infection of the scalp. The fungi can invade the hair follicles, leading to hair loss. In addition to hair loss, kids with this condition may have scaly, dandruff-like scalps or yellow crusts on their skin. The fungus can be spread by hairbrushes, towels, and even the backs of chairs. 
  • Some children may have hair loss due to trichotillomania, which is also called hair-pulling disorder. Kids with this mental disorder have the urge to pull out their own hair. This can leave them with patchy bald spots on their scalp. Children with trichotillomania may also pull hair from their eyelashes, eyebrows, or other parts of their body. 
  • Another common cause of hair loss in kids is telogen effluvium. In this condition, about 30% of a child’s hair stops growing and falls out. This can lead to thinner hair or bald patches on the head. It can be triggered by major physical trauma, severe infections, extreme weight loss, and other serious stresses. It can also be caused by another medical condition, such as hypothyroidism or an iron deficiency.

Non-medical causes of hair loss in children

Parents of balding kids may be concerned about medical conditions, but there are many non-medical causes of hair loss in children. Children may lose their hair due to tight hairstyles, heat styling, or harsh chemicals. Friction may also cause hair loss. 

Harsh hairstyling practices such as excess heat from blow dryers or hair straighteners can damage the hair, leading to hair loss. Hair loss can also occur if children pull their hair into tight buns, ponytails, or braids, damaging their hair follicles. Harsh chemicals, like those used to dye hair, are another possible cause of hair loss. 

Children may lose their hair due to tight hairstyles, heat styling, or harsh chemicals. Friction may also cause hair loss.

Sometimes, friction can lead to hair loss. This can happen to babies who repeatedly rub their heads against cribs, car seats, or other surfaces. This type of hair loss can be distressing, but babies usually outgrow this behavior as they get older. 

Ways to manage alopecia in children

Once the underlying cause of the hair loss has been determined, it can be treated. The treatment will vary based on the cause, and in some cases, treatments aren’t available. Some kids may need a cosmetic solution, such as a wig. Since hair loss can be very upsetting for kids, they may need to see a psychologist or other mental health professional. 

The treatment for hair loss in kids will vary depending on the condition that caused it. For kids with alopecia areata, the treatment may involve corticosteroids. For kids with tinea capitis, doctors may recommend antifungal pills or antifungal shampoos. Children with trichotillomania may be helped by habit reversal training, cognitive therapy, and other therapies. 

Understandably, balding kids may feel depressed or humiliated about their condition. They could also be bullied, leading to social isolation or low self-esteem. In these cases, kids may benefit from the help of a psychologist or psychiatrist.

For some conditions, such as telogen effluvium, there aren’t any effective treatments. Fortunately, telogen effluvium usually clears up on its own after six to nine months, and the hair will grow back. However, the condition can last longer, and the hair might not fully regrow. Doctors may suggest cosmetic measures to help conceal the hair loss. These measures could include wigs or false eyelashes.

No matter what caused a child’s hair loss, the situation can be very upsetting. Understandably, balding kids may feel depressed or humiliated about their condition. They could also be bullied, leading to social isolation or low self-esteem. In these cases, kids may benefit from the help of a psychologist or psychiatrist. 

Tips for taking care of children's hair

Children who are balding due to hair care practices may benefit from a new routine. Good hair care habits can help protect the hair from damage. This may include choosing loose hairstyles and avoiding heat styling and harsh chemicals. 

Since tight hairstyles can damage hair follicles, dermatologists recommend loose ponytails and braids. Hairstyles that don’t require heat are best, but if children want hairstyles that require blow dryers or hair straighteners, use a lower heat setting. Harsh hairstyling chemicals, such as dyes and relaxers, can also cause damage. Avoid these chemicals or use them less often to protect your child’s hair. 

When to seek professional help

Some degree of hair loss is normal — people usually lose about 100 hairs per day (around 200 with shampooing). It’s normal to see some hair loss when you brush or wash your child’s hair. If you think your child is losing an abnormal amount of hair, or if they have noticeable hair loss or bald spots, take them to a doctor. Sudden hair loss or patchy areas on the scalp could also be signs of a medical condition, so talk to your child’s doctor. 

If you’re worried about your child’s hair loss, talk to their pediatrician. Many causes of hair loss or alopecia in children are treatable.

Many medical conditions can cause hair loss or alopecia in kids, and nonmedical causes can also be to blame. If you’re worried about your child’s hair loss, talk to their pediatrician. Many causes of hair loss or alopecia in children are treatable.

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