From the Guidelines
Hair loss in the pediatric population can result from several causes, including tinea capitis, alopecia areata, traction alopecia, trichotillomania, telogen effluvium, nutritional deficiencies, endocrine disorders, and genetic conditions. The most common causes of hair loss in children include:
- Tinea capitis (fungal infection of the scalp)
- Alopecia areata (an autoimmune condition causing patchy hair loss)
- Traction alopecia (from tight hairstyles)
- Trichotillomania (compulsive hair pulling)
- Telogen effluvium (stress-induced shedding)
- Nutritional deficiencies (particularly iron, zinc, and protein) 1
- Endocrine disorders (like hypothyroidism)
- Genetic conditions such as loose anagen syndrome Some children may experience hair loss from medications, particularly chemotherapy drugs. Congenital conditions like aplasia cutis or ectodermal dysplasia can also cause hair abnormalities. Inflammatory conditions such as lichen planopilaris, though rare in children, can cause scarring alopecia. Treatment depends on the specific cause and may include antifungal medications for tinea capitis, corticosteroid injections or topical treatments for alopecia areata, behavioral therapy for trichotillomania, or nutritional supplementation for deficiency states 1. Early diagnosis is important, especially for conditions like tinea capitis which can cause permanent scarring if left untreated. A thorough history, physical examination, and sometimes laboratory tests or scalp biopsy are necessary to determine the underlying cause and guide appropriate treatment. It is essential to consider the psychological impact of hair loss on children, and referral to a pediatric clinical psychologist, educational psychologist, or social worker may be needed if a significant change in a child's behavior or self-esteem is observed 1.
From the Research
Causes of Hair Loss in the Pediatric Population
- Hair loss in children can be caused by various factors, including:
- Alopecia areata, an autoimmune condition that causes hair loss on the scalp and/or body 2
- Tinea capitis, a fungal infection of the scalp 3, 4
- Androgenetic alopecia, a condition that causes hair loss due to hormonal imbalances 3
- Traction alopecia, a condition that causes hair loss due to constant pulling or tension on the hair 3, 4
- Trichotillomania, a psychological condition that causes individuals to pull out their own hair 3
- Hair cycle disturbances, such as telogen effluvium, which can cause excessive shedding of hair 5
- Congenital alopecia conditions, such as ectodermal dysplasias 4, 6
- Other factors that can contribute to hair loss in children include:
- Infections, such as fungal or bacterial infections 4
- Nutritional deficiencies, such as iron or zinc deficiency 4
- Medications, such as those used to treat cancer or autoimmune disorders 4
- Trauma or physical stress, such as that caused by hair styling or grooming practices 4, 5
- Emotional or physiological stress, such as that caused by anxiety or depression 5