Causes of alopecia or hair loss

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 normal before your baby’s permanent hair starts growing.

Also, healthy babies often have bald patches at the backs or sides of their scalps. This is because they lie on their backs a lot of the time, so their heads often rub against something. Your baby’s hair will grow normally when he can spend more time sitting up.

Abnormal hair loss
There are several causes of abnormal hair loss in children and teenagers.

Ringworm is a common cause of abnormal hair loss.

Alopecia areata is a common skin condition that causes hair loss from different parts of the body. It doesn’t scar, but older children can feel distressed if they lose hair from large or noticeable areas.

Older children might pull out their hair as a kind of nervous habit. Some children pull at their eyebrows and eyelashes also. This is known as trichotillomania and can be a sign of an emotional disorder.

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 attached 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 GP.

Symptoms of alopecia or hair loss

The main symptom of hair loss is a bald or thinning patch.

If your child has ringworm or impetigo, she might complain of an itchy or tender scalp too. With ringworm, you might also see some redness and scaling in your child’s bald patch, as well as some short, dull and bent hairs, which are only a few millimetres in length.

If your child has alopecia areata, the patch will be completely bald, and the scalp won’t have any signs of scaling, redness or scarring. It isn’t itchy or tender. This condition can happen anywhere on the scalp, eyebrows, eyelashes or hairy areas of the body.

In trichotillomania, the bald patches are usually at the front or side of the scalp. The patches are never completely bald, might be an irregular shape, and will have hairs of different lengths.

When to see your doctor about alopecia or hair loss

You should take your child to see your GP if your child:

  • has significant hair loss or thinning for no apparent reason
  • has an itchy or tender scalp
  • is generally unwell, in addition to hair loss.

If your child is losing hair from large areas and is feeling upset or stressed about it, it might be a good idea to ask your GP for a referral to a dermatologist.

Treatment for alopecia or hair loss

Treatment for hair loss involves treating the underlying cause, and reassuring your child that the hair will regrow and won’t cause scarring.

Small patches of alopecia areata that don’t grow in size can sort themselves out without treatment.

If your child’s bald patches are getting worse, your doctor might prescribe corticosteroid cream or another treatment for a few weeks.

Some older children might feel upset or stressed about their bald patches. Talking with a GP or counsellor might help.

Prevention of alopecia or hair loss

Be careful when combing, brushing and shampooing your child’s hair, because pulling too hard on hair shafts can cause hair loss. Also, try not to make ponytails or pigtails too tight. And avoid using hair straighteners or chemicals on your child’s hair.