Causes
Normal hair loss
Sometimes children have bald patches on the scalp because of hair loss. Many babies are bald from birth, or lose their hair shortly afterwards. This is a normal pattern before their permanent hair starts growing.
Also, healthy babies will often have a bald patch at the back or side of the scalp because of occasional rubbing caused by lying on the mattress of their cot or in baby seats. Normal hair will grow when your baby can spend more time sitting up.
Abnormal hair loss
The most common cause of abnormal hair loss is ringworm.
In other cases, older children might pull out their hair as a kind of nervous tic. This is known as trichotillomania and can indicate some sort of emotional disturbance.
Some children might have incomplete hair loss in areas of their scalp that are repeatedly brushed or combed firmly. This is because of immature hair follicles and because the hair shaft is poorly anchored to the scalp. This pattern of hair loss will sort itself out gradually as your child grows.
If you notice your child’s hair thinning, it could be a sign of thyroid gland problems. Thyroid disease is rare in children, but if you notice this symptom, discuss it with your doctor.
If the cause of your child’s hair loss is unknown, it might be alopecia areata (a skin condition that runs in families), where hair is lost from different areas of the body.
Symptoms
The main symptom of hair loss is a bald patch. If your child has ringworm or impetigo, she might complain of an itchy scalp. With ringworm, you might also see some redness and scaling in your child’s bald patch, as well as some short, lustreless and bent hairs a few millimeters in length.
In trichotillomania, bald patches are usually at the front or side of the scalp. The patches are never completely bald and will contain hairs of different lengths.
If your child has alopecia areata, the bald patch will usually be completely bald, and the scalp won’t have any signs of scaling, redness or scarring.
When to see your doctor
Go to the doctor if your child:
- has significant hair loss for no apparent reason
- has an itchy scalp
- is generally unwell, in addition to hair loss.
Treatment
Treatment for hair loss consists of treating the underlying cause, and reassuring your child that the hair will regrow and won’t cause scarring. Some older children and adolescents might find the appearance of bald patches stressful – talking with a doctor or counsellor might help.
Small patches of alopecia areata that don’t grow in size will usually sort themselves out without treatment.
If your child’s bald patches are getting worse, your doctor might prescribe steroid medication for a few weeks.
Prevention
Be careful when combing, brushing and shampooing your child’s hair – pulling too hard on hair shafts can cause hair loss. Also, try not to make ponytails or pigtails too tight.
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