Hair Loss in Children: Common Reasons Parents Should Know

Hair loss in children can be quite frustrating and scary for parents. The good news is that most of the condition of hair loss in children is often temporary and can be effectively treated with proper diagnosis. One must understand that some cases of children with hair loss can be effectively treated with medications while for some medications may not work until the causative factor is avoided. This article will brief on some of the common causes of hair loss in children and their management.

The most common causes of hair loss in children are:

• Telogen effluvium (stress-related shedding)
• Tinea capitis (fungal infection)
• Alopecia areata (autoimmune)
• Traction alopecia (tight hairstyles)
• Nutritional deficiencies (iron, zinc, protein)
• Scalp conditions (seborrheic dermatitis, psoriasis)
• Trichotillomania (hair pulling)

 

Telogen Effluvium

Telogen effluvium is one of the common causes of hair loss in children. Children often have recent illness, usually high fever, flu, surgery, severe emotional stress, sudden weight loss. About 1-3 months following illness, your child may have hair loss. But then their hair begins to grow again in about six months without any treatments. The hair loss in TE doesn’t have specific pattern like patches but rather appears thin throughout the scalp. It is thought that this hair loss occurs because the hairs those were in their growth phage suddenly transform into resting phage. Hairs then falls out until new hair grow then follow the normal growth phase. Hair usually takes around 3 and 6 months to re-enter into growth phase.

Common Triggers

• Fever or infection
• Surgery
• Major stress
• Nutritional deficiency
• Viral illnesses

Treatment

• Usually resolves in 3–6 months
• Balanced diet + multivitamins
• Reducing physical/emotional stress

It’s temporary and rarely requires medication.

Tinea Capitis

Tinea capitis or ringworm of the scalp is another cause of hair loss in children that are caused by fungus which invades the hair shaft resulting in breakage of hair. They have more recognizable signs and symptoms with itching and circular or oval patches of lesion with hair loss. Hair is usually broken at the surface of the skin and the remaining looks like black dots on the scalp. Tinea capitis can be transmitted by contact from infected individual through the sharing of combs, brushes, hats, towels etc. Boys tend to be affected more than girls and most commonly seen among 3-10 years.

Tinea capitis can be easily treated with topical antifungal however if left untreated it can be very tender and infected leading to kerion. Several anti-fungal options are available in the form of shampoo, creams and lotions that can effectively treat tinea capitis. If the infection is extensive and unresponsive to topical medication, oral anti-fungal medications in combination with topical medication can effectively cure tinea capitis.

Key Symptoms

• Round or irregular bald patches
• Scaling, flaking, “dandruff-like” particles
• Itching
• Black dot appearance (broken hairs)
• Swollen lymph nodes in some cases

Treatment

• Oral antifungals (Griseofulvin or Terbinafine or Itraconazole)
• Antifungal shampoo (ketoconazole)
• Treat siblings if needed

Pro Tip: Without treatment, it gets worse—early detection prevents scarring.

Bacterial Infections

Sometime bacterial infection also can cause hair loss in children. It is often temporary and resolves once the infection is treated.

Traction Alopecia

Traction alopecia or physical damage of the hair is also common in children especially schooling girls who wear tight braids and ponytails with ribbons in it. In case of newborn and infant they can lose hair on the back of their head due to constant rubbing against their bed. Other factors that can cause traction alopecia are combing, curling, stratening, fluffing etc. This can lead to hair follicle damage and may take upto 3-4 months to heal before they start to grow again.

Common in children who wear:

• Tight ponytails
• Braids
• Buns
• Banded hairstyles

Symptoms

• Hair loss along the hairline
• Broken hairs
• Redness or bumps on scalp

Treatment

• Loosen hairstyles
• Avoid heat/chemical styling
• Use soft scrunchies

Prolonged traction can cause permanent scarring, so early intervention is important.

Hair Pulling

Just like thumb sucking, many children have habits of pulling their hair which can lead to hairfall. It usually stops when they reach 3-4 years old. In order to avoid hair pulling you may get a short haircut for your child.

Trichotillomania

Some child may have obsession of compulsive hair pulling which is classified under obsessive-compulsive disorder. This usually happens when child is in tension, nervous or can’t resist pulling and feels pleasure and relief when pulling their hair. Hair loss in trichotillomania can be quite noticeable with irregular patches of incomplete hair loss with broken hairs of varying length. This may sometime include eyebrows and eyelashes as well. The habit of pulling hair is often encountered when the child is studying, watching TV or few moments before sleep.

In most cases avoiding the habit and the causative factors like emotional stress or other psychological issues should resolve the case spontaneously and hair will start to grow back. Never scold your children if you notice him/her pulling hair, a better counselling that can help your child deal with the issues is an good option.

Symptoms

• Patchy hair with broken lengths
• Child often denies pulling
• Occurs during stress or anxiety
• Irregular borders of bald patches

Treatment

• Behavioral therapy
• Stress reduction
• Sometimes psychiatric support

Alopecia Areata

Although exact cause of hair loss is a mystery, alopecia areata is considered as autoimmune disorder (immune system mistakenly attacks own hair follicles). This lead to complete hair loss in round or oval patches but unlike ringworm the area involve is smooth with no scaling, redness or broken hairs. It is estimated that in about 20-30% of cases there is usually family history of hair loss in this pattern. Ridging or pitting of the nails is also seen in around 25% of the children with alopecia areata. In about 5% of the children, alopecia areata may progress to alopecia totalis. Good news is that new hair grows back within a year in more than 80% of the children with alopecia areata.

Although there is no cure for alopecia areata, several medications have been tried in an attempt to stimulate the hair growth with mixed results. Intralesional injection of corticosteroids (triamcinolone acetonide) is often used with satisfactory result. Other options are topical corticosteroids and Immunomodulators like tacrolimus. In addition minoxidil has been used successively in most cases of alopecia areata.

Key Symptoms

• Smooth round bald patches
• No redness or scaling
• “Exclamation-mark” hairs at borders
• Sudden onset

Treatment

• Topical corticosteroids
• Minoxidil
• Immunotherapy (in resistant cases)
• Psychological support

It is not contagious and doesn’t affect general health.

Alopecia Totalis and Alopecia Universalis

In case of alopecia totalis all the scalp hair is lost and in alopecia universalis all the body hair including scalp is lost. In this case the possibility of hair regrowth is less. Treatment are topical steroids, Immunomodulators, oral steroids, and light therapy.

Scalp Conditions (Dermatitis, Psoriasis, Eczema)

Inflammatory skin diseases can affect the scalp.

Symptoms

• Red, inflamed, scaly scalp
• Flakes or crusting
• Mild to moderate hair thinning

Treatment

• Medicated shampoos
• Anti-inflammatory creams
• Dermatologist evaluation

 

 Other Causes of Hair Loss

In addition to the above mentioned causes, there are several other causes of children hair loss which are listed below:

• Malnutrition
• Thyroid disorders (hyperthyroidism and hypothyroidism)
• Chronic illness like diabetes, systemic lupus erythematous
• Iron deficiency anemia
• Excessive vitamin A intake
• Biotin, zinc and other minerals deficiency
• Structural abnormalities of the hair shaft leading to dry, brittle and easy breakage of hair.
• Chemotherapy and radiation therapy (anagen effluvium)

When Should Parents Worry?

Seek a dermatologist immediately if:

• Bald patches are increasing
• Child has pain, swelling, or pus
• Hair loss started suddenly
• Hair isn’t growing back
• Scalp looks infected
• The child is emotionally distressed

Early diagnosis = better outcomes.

How Dermatologists Diagnose Hair Loss in Children

A  dermatologist may perform:

• Scalp examination
• Trichoscopy (microscope exam)
• Fungal culture
• Blood tests (iron, thyroid, vitamin levels)
• Scalp biopsy (rare)

 

Can Hair Grow Back?

Yes — in most cases.
With proper treatment, children can regain full, healthy hair growth unless scarring has occurred.

 

FAQs Hair loss in children

1. Is hair loss normal in children?

Mild shedding is normal, but visible bald patches or sudden thinning require evaluation.

2. Can stress cause hair loss in kids?

Yes, stress can trigger telogen effluvium, leading to temporary shedding.

3. What vitamin deficiency causes hair loss in children?

Iron, vitamin D, zinc, and protein deficiencies are common contributors.

4. How do I know if my child has alopecia areata?

Look for smooth, round bald patches without scaling or redness.

5. Does dandruff cause hair loss in children?

Severe scalp inflammation like dermatitis or fungal infection can lead to shedding.

6. Can hair loss in kids be prevented?

Gentle hair care, good nutrition, and early treatment of scalp infections help prevent most cases.