Raechele Cochran Gathers, MD “I took my daughter to the doctor for hair loss that is in a round patch in the back of her head. He said it was alopecia and prescribed clotrimazole cream. I have been rubbing it on three times a week. It seems to still be growing and I am still concerned. nShould I give it some more time to start healing or should I ask the doctor for more like a shampoo and internal meds? My child is 2 and a half and has beautiful thick African American hair. A full head of hair until the patch started forming 4 weeks ago. Please help!”
Hair loss in a child can be traumatic. When a child suffers from diseases of the skin or hair, it can be incredibly devastating. In most cases, hair loss in a child is not physically dangerous or life threatening, but it can take a large emotional toll. Even worse, others can be very cruel to someone that looks different from most other people.
What Causes Hair Loss in a Child?
Alopecia is the word that doctors use for hair loss. There can be many different causes of hair loss in a child. Causes of hair loss in a child can include:
- Infection
- Autoimmune conditions
- Vitamin deficiencies
- Illness
- Anemia or other blood condition
- Medications
- Trauma from styling practices
A child with hair loss will need a doctor that is not only knowledgeable, but also a good detective, to get to the root cause of the problem.
7 Common Causes of Hair Loss in a Child
1. Ringworm
Ringworm of the scalp, also known as tinea capitis, is actually relatively common in children, especially black children. While the condition is typically not harmful internally, it can cause hair loss and inflammation on the scalp. It is also contagious! Ringworm of the scalp is sometimes missed by doctors. So, if your child has hair loss, make sure that your doctor has tested your child for a fungal infection. Typically, your doctor can test for ringworm by doing a simple test called a fungal culture. This test is quick and won’t hurt your child at all! Tinea capitis is typically treated with an oral antifungal medication for a few weeks, and most children respond beautifully. Ringworm of the scalp can affect adults as well! Read about it here.
Tinea Capitis
2. Alopecia Areata
Alopecia areata is also a relatively common cause of hair loss in a child. It’s an autoimmune condition, where inflammation around the hair follicles causes the hair to fall out. It can cause one bald spot, many bald spots, or even total baldness. Alopecia areata is not harmful or deadly, but it can take a psychological toll on kids and their families. If your child has alopecia areata, a good resource is the National Alopecia Areata Foundation. A child with hair loss from alopecia areata may be treated with steroid creams or steroid shots or anthralin. There are also other treatments available for people with more resistant hair loss from alopecia areata.
Alopecia Areata
3. Telogen Effluvium
Telogen effluvium is a type of excessive hair shedding. It can also cause hair loss in a child. Telogen effluvium is not life threatening or contagious. Telogen effluvium occurs after a trauma or shock to the system. In children, it can occur after a surgery, a high fever or after a physical or emotional trauma. You don’t notice hair loss right away in telogen effluvium. It usually doesn’t happen until 3-4 months after the traumatic event. Telogen effluvium can cause hair loss in a child because more hairs than normal are in the telogen (resting) phase. Instead of losing the normal 100 or so hairs a day, a child can lose 300 or more hairs a day! After a while, telogen effluvium usually resolves on its own, and the child’s hair grows back. Read more about hair growth phases and telogen effluvium here.
4. Trichotillomania
Trichotillomania is also a relatively common cause of hair loss in a child. Children with trichotillomania pull out their own hair. Trichotillomania is considered a form of OCD (obsessive-compulsive disorder). Some children are aware that they’re pulling their own hair out, but other children are not! Children with trichotillomania can be helped with cognitive behavior therapy to make them aware of their hair pulling and give them strategies to avoid the behavior. Once the hair pulling behavior stops, the hair typically regrows.
5. Hair Styling Practices
Hair loss in a child can also be caused by hair styling practices that are traumatic. Traction alopecia can occur in a child after tight braids or ponytails. Traction alopecia can cause thin edges or hair loss in other parts of the scalp too. Likewise, hair loss in a child can be caused by damage from a relaxer that causes breakage, or even from heat damage if too high a temperature was used to straighten a child’s hair.
6. Thyroid Problems
Thyroid problems can cause hair loss in a child. The thyroid gland helps regulate metabolic rate and many other important bodily functions. Thyroid problems can sometimes be caused by autoimmune conditions. A low thyroid can cause hair loss, weight gain, tiredness and skin problems. Typically, once the thyroid condition is addressed, a child’s hair will begin to regrow.
7. Deficiencies
Restrictive diets or calorie restriction can also cause hair loss. Hair loss in a child can happen if your child is not getting enough of the vitamins and minerals that are essential for healthy hair growth. Eating disorders like anorexia and bulimia can also cause hair loss in a child. Low levels of iron, biotin, niacin and protein can all be associated with hair loss.
Conclusion
Hair loss in a child is traumatic for both the child and parents. If your child has hair loss, it’s super important to take them to see a physician immediately. Most causes of hair loss in a child are common and treatable. But it’s important to get that diagnosis and develop a management plan right away.
Photo credit: Alopecia Areata: Indian J Paediatr Dermatol 2016;17:173-8
