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Ask the Pediatrician: What is hair loss (alopecia) in children?

Keri Wallace, MD, FAAP, American Academy of Pediatrics on

Published in Health & Fitness

Hair loss (alopecia) may not be as common in kids as adults, but there are variety of a reasons it may happen. While it can be upsetting for both parents and children, the condition usually improves once the cause is identified and addressed.

There are different causes of hair loss in infants, children and teens. The most common reasons depend on the child's age. In most cases, hair that is lost grows back on its own. There are treatments available when the hair is not growing back.

Hair loss is very common in newborns and young babies. Almost all babies will have some—and possibly all--of their hair fall out during the first few months of life. This is normal and to be expected—the hair will grow back.

Some babies will lose more hair on the back of their heads than other parts of the scalp. Don't worry—this is not unusual, and the hair grows back normally over a few months.

Hair loss in older children can have a variety of causes. Some of the more common reasons a child or teen may lose hair include:

Hair that is styled tightly (like in tight braids or frequent tight ponytails or buns) can cause hair loss, especially along the edges of the scalp at the front, sides and back. This condition is called traction alopecia. It can get better by changing to looser hair styles. Avoiding caps and other things that constantly rub on the scalp can also help the hair grow back.

 

Stress. Physical stress (like high fever, hospitalization or surgery) or emotional stress (like a death in the family, a new school or a new home) may cause more hair to fall out than normal. This type of hair loss, called telogen effluvium, can happen over a few weeks or months. The condition makes the hair seem thinner than it was before, but doesn't cause bald patches or complete loss of hair. Telogen effluvium hair loss gradually gets better on its own.

A child’s habit of twisting or pulling their hair, which is called trichotillomania. Many children who develop this behavior often don't even realize they are doing it. Trichotillomania can cause the hair to break and fall out, leading to patches on the scalp with less hair than normal and broken off stubble hairs. Very young children tend to outgrow this habit. Older children and teens may benefit from counseling and mental health care to break the habit.

A fungal infection can sometimes cause hair loss. Ringworm is a fairly common fungus infection of the skin or the hair. The medical terms for these infections are tinea corporis and tinea capitis. When this infection is on the scalp, the hairs break and fall out and the skin can look irritated and flaky. Treatment with an anti-fungus medicine given by mouth is necessary to clear this infection from the scalp.

Alopecia areata is an autoimmune disease that can affect people of any age, including children. It happens when the immune system, which is supposed to protect us and fight germs, instead attacks the hair follicles and causes hair to fall out.

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