From the Guidelines
Hair loss in a 2-year-old child can be caused by several conditions, with the most common being tinea capitis, a fungal infection that requires treatment with oral antifungal medications. The possible causes of hair loss on a 2-year-old child's head include:
- Tinea capitis, a fungal infection that requires treatment with oral antifungal medications like griseofulvin (10-20 mg/kg/day for 6-8 weeks) or terbinafine (based on weight, typically for 2-4 weeks) 1
- Alopecia areata, an autoimmune condition causing patchy hair loss, which may occur in children and often resolves spontaneously but sometimes requires topical steroids prescribed by a dermatologist 1
- Trichotillomania, where a child pulls their own hair, is another possibility that may require behavioral intervention
- Physical trauma from tight hairstyles or friction against bedding can cause traction alopecia or pressure-related hair loss
- Nutritional deficiencies, particularly of iron, zinc, or protein, may contribute to hair thinning, although the evidence for iron deficiency is conflicting 1
- Some children experience telogen effluvium, temporary hair shedding following illness, stress, or fever
- Rare causes include hypothyroidism, which requires thyroid hormone replacement, or genetic conditions like loose anagen syndrome If you notice hair loss in your child, consult a pediatrician promptly for proper diagnosis and treatment, as the underlying cause determines the appropriate management approach.
From the Research
Possible Causes of Hair Loss in a 2-Year-Old Child
The possible causes of hair loss on a 2-year-old child's head include:
- Alopecia areata: an autoimmune disease that causes hair loss in usually sharply defined areas, ranging from small patches to extensive or diffuse involvement 2
- Tinea capitis: a fungal infection of the scalp that can cause hair loss, characterized by comma-shaped hairs, corkscrew hairs, and zigzag-shaped hairs on trichoscopy 3
- Trichotillomania: a condition where a person pulls out their own hair, often due to stress, anxiety, or other emotional issues
- Telogen effluvium: a condition where there is a significant increase in hair shedding, often due to hormonal changes or stress
- Traction alopecia: a condition where hair loss occurs due to constant pulling or tension on the hair, often due to hairstyles such as braids or ponytails
Diagnostic Features
Trichoscopy, a non-invasive diagnostic tool, can be used to identify subtle details and establish the correct diagnosis of hair loss in children. The trichoscopic features of alopecia areata include:
- Yellow dots
- Short vellus hairs
- Black dots
- Broken hairs
- Exclamation mark hairs 4 The trichoscopic features of tinea capitis include:
- Comma-shaped hairs
- Corkscrew hairs
- Zigzag-shaped hairs 3
Clinical Features
The clinical features of common causes of hair loss in children include:
- Androgenic hair loss: characterized by thinning of hair on the scalp, often due to hormonal imbalances
- Alopecia areata: characterized by acute onset of non-scarring hair loss in usually sharply defined areas
- Trichotillomania: characterized by broken hairs of varying lengths, often with an irregular shape
- Tinea capitis: characterized by circular patches of hair loss, often with erythema and scaling 5