Hair loss in children

Fungal scalp infections can be common amongst children that share hair accessories with affected children. It is either called tinea capitis or scalp ringworm. They may experience patchy hair loss with black dots where the hair has broken. Samples of the skin can be sent to the lab for confirmation of diagnosis, but it is usually diagnosed by looking at it. Treatment includes antifungal shampoo and oral medication taken for 2 months.

Alopecia areata is an autoimmune condition in which the body attacks itself causing hair loss. There are different and varying severities of alopecia, but there is no cure. Treatments can be tried to encourage hair growth, such as minoxidil lotion or sometimes steroid creams.

Children undergoing chemotherapy treatment are likely to experience hair loss, as the treatment targets fast-growing cells, which includes hair follicles. Hair should start to regrow once treatment has finished.

Telogen effluvium is where hair falls out as more hair follicles enter the arrest phase of the hair growth cycle. It’s usually in response to stressful events such as illness, emotional trauma or surgery. Once the stressful event has passed, hair should grow back 6 to 12 months later.

Trichotillomania is a fancy name for hair pulling. This can occur as a response to stress or without them realising, as a type of obsessive-compulsive disorder. You may notice your child pulling or twirling their hair repetitively, or you may notice patchy areas of hair loss or broken hair. Your doctor may refer your child for cognitive behavioural therapy to examine the thought processes linked to their behaviour.

In a similar way to pulling and twirling hair, certain hairstyles can cause tension on the hair and weaken the follicles. Tight ponytails, braids, and wearing hairpieces, hats and extensions regularly can cause friction that leads to hair loss. Chemicals such as dyes and relaxers or excessive heat, from blowdryers, curling tongs, straighteners or hot combing, can cause a similar trauma to hair follicles.

Stopping these irritants and allowing for looser hairstyles will help follicles recover with time.

A lack of certain vitamins and minerals can cause hair to fall out, such as iron, zinc, niacin and biotin. These aren't easily tested to see the level of deficiency, but do ensure your child is eating nutritionally balanced and wholesome meals. It may be helpful to take regular multivitamin supplements.

Hypothyroidism can also account for hair loss, alongside other symptoms - a doctor can organise a blood test looking for this.

The best thing to do is to prevent further hair loss, where possible. This may mean addressing any vitamin deficiencies, stresses or psychological trauma, and changing their hairstyle or headwear if this could be the culprit. If you think it may be a fungal infection or autoimmune condition underlying it.

It’s always best to start with first principles: maintain a healthy, well-balanced diet and encourage regular exercise, to encourage blood flow around the body and stimulate the hair follicles.

You can see your doctor about hair loss if you are unsure of the cause. They may suggest anti-fungal treatment if a fungal infection is likely (and for other children in the household, as it’s highly contagious), or steroid cream if it’s an autoimmune condition, although this would likely be under the supervision of a paediatrician or dermatologist.

Adults have a few medicated products that can be used to stimulate hair loss, but these are not usually advised for children.

Alternative hairstyles, hairpieces, wigs and hats can be used to disguise areas of hair loss and increase their confidence.