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Hair loss in children

Hair loss, or alopecia, can be a concern for a child and their parents, whether a child has thinning hair or develops bald spots.

Learn about the causes and treatments for hair loss in children.

Medical causes of hair loss in children

For the majority of children suffering hair loss, one of the following conditions is the cause. Your child's GP, or a paediatrician or paediatric dermatologist, should be able to diagnose these conditions and prescribe the appropriate treatment.

Tinea capitis. Tinea capitis, commonly known as ringworm, is a fungal infection often seen in children. It can show up in a number of ways, but the most common is as scaly patches of hair loss on the head. The patches are usually round or oval. The hairs can be broken off at the surface of the skin and look like black dots on the scalp.

If your child's doctor suspects tinea capitis, a culture can confirm the diagnosis. Treatment may involve an oral antifungal and or an antifungal shampoo to decrease shedding of the fungus.

Because ringworm is contagious, your child should be careful not to share any objects that touch the head, such as hats, pillow-cases or brushes.

Alopecia areata. Alopecia areata is a condition of hair loss thought to be caused by the body's immune system attacking the hair follicles. It is characterised by the sudden appearance of round or oval patches of hair loss. The patches are slick or smooth, without scaling or broken hairs. About 25% of children with this condition also have pitting and ridging of the nails.

While there is no cure for alopecia areata, treatment can control the disease in some children. Many have their hair back within a year. However, for about 5% of children, the disease progresses to alopecia totalis - the loss of all of the hair on the scalp. Some of these children will develop alopecia universalis - a total loss of body hair.

For younger children, treatment consists primarily of strong corticosteroid ointments or creams applied to the bald areas. Teenagers, who may be sufficiently motivated to have their hair return, may tolerate steroid injections into the scalp. Minoxidil is often used in addition to topical steroid treatment.

Trichotillomania. Trichotillomania is hair loss caused by pulling, plucking, twisting or rubbing. The hair loss is patchy and characterised by broken hairs of varying length. Patches are typically seen on the side of the child's dominant hand.

Trichotillomania may be triggered by a stressor in your child's life, such as the loss of a grandparent, birth of a sibling or a divorce. If you notice your child pulling hair, scolding is not likely to be helpful. However, counselling to help your child deal with the source of stress that triggered the habit may help stop it.

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