Hair loss in children: common causes for parents

Hair loss in children is less common than in adults, and the causes are often different. Many are treatable, and some settle on their own. The key is to look carefully at the pattern and see a doctor early when needed.

Normal changes in babies

Many babies lose some or most of their hair in the first months of life. A bald patch at the back of the head is also common in young babies, from rubbing against the mattress. This usually fills in as the baby spends more time sitting up. Neither needs treatment. Shaving a baby's head is a common family practice but does not change how thick the hair will be later. See does shaving make hair thicker?.

Common causes of hair loss in children

Scalp ringworm (tinea capitis)

Tinea capitis is a fungal infection of the scalp and is one of the most common causes of hair loss in school-age children ^{1 2}. Signs include:

• Scaly, round patches with broken hairs
• Itching
• Sometimes black dots where hairs have broken at the scalp
• Occasionally a painful, swollen, pus-filled lump called a kerion

It spreads through close contact and shared combs, towels, pillows and caps. Tinea capitis needs antifungal medicine taken by mouth; creams alone are not enough ^{3 2}. An antifungal shampoo may be advised to reduce spread. Family members and pets may need checking.

Alopecia areata

Alopecia areata causes smooth, round bald patches, often appearing suddenly. It happens when the immune system targets hair follicles ^{4 5}. In many children with small patches, hair grows back, though patches can recur. A doctor can discuss treatment options. See can alopecia areata go away?.

Traction alopecia

Tight ponytails, braids, buns and hair accessories pulled tightly every day can cause hair loss along the hairline and partings ^{6 7}. This is common in girls who wear their hair tightly tied for school. Loosening styles early usually allows recovery. See hijab and hair loss for tips if your child wears a tudung.

Hair pulling (trichotillomania)

Some children pull, twist or play with their hair, often when stressed, bored or tired. This causes irregular patches with hairs of different lengths ^{8 9}. Many young children grow out of it. Gentle support, not punishment, is important, and a doctor can refer for behavioural support if needed.

Shedding after illness (telogen effluvium)

A high fever, serious illness, surgery or major stress can cause widespread shedding two to three months later. It usually recovers within months ¹⁰. In Malaysia, this is sometimes seen after dengue or other febrile illnesses.

Nutrition and other medical causes

Low iron, restricted diets, thyroid problems and some other medical conditions can affect hair ^{11 12}. A doctor may suggest blood tests. See blood tests for hair loss.

Pattern hair loss in teenagers

Pattern hair loss can start in the teenage years, especially with a strong family history ¹³. It looks like gradual thinning at the temples or crown in boys, or a widening parting in girls. Teenage girls with thinning hair, irregular periods and acne may need checking for hormonal conditions such as PCOS.

What parents can do

• Look closely. Note whether the loss is patchy or all over, and whether there is scaling, redness, broken hairs or pus.
• Take photos to track change over weeks.
• Do not share combs, brushes, towels, caps or pillows if ringworm is possible.
• Loosen hairstyles and avoid tight ties.
• Offer balanced meals with protein, iron-rich foods, fruit and vegetables.
• Reassure your child. Hair loss can affect confidence, especially at school. Let teachers know if teasing is a problem.

When to see a doctor

See your family doctor or paediatrician if your child has:

• Bald or scaly patches
• Broken hairs, black dots or a painful swollen lump on the scalp
• Loss of eyebrows or eyelashes
• Widespread shedding or thinning
• Hair loss along with tiredness, weight change or other symptoms

Your doctor may refer to a dermatologist if needed ¹⁴. See when to see a dermatologist.

The bottom line

Most hair loss in children has a clear cause, such as a scalp fungal infection, alopecia areata, tight hairstyles, hair pulling or recent illness. Many of these are treatable or improve with time. Early assessment helps, especially for scalp ringworm, which needs proper antifungal treatment.

Frequently asked questions

What is the most common cause of hair loss in children?

Scalp ringworm (tinea capitis) is one of the most common causes in school-age children ¹.

Can scalp ringworm be treated with cream?

No. Tinea capitis needs antifungal medicine taken by mouth; creams alone are not enough ³.

Will my child's alopecia areata patch grow back?

In many children with small patches hair grows back, though patches can recur ⁵.

Can tight ponytails cause hair loss in girls?

Yes. Repeated pulling can cause traction alopecia along the hairline ⁶.

Educational content. Not medical advice.