You might not be surprised, as you get older, to notice that your hair is starting to fall out. Yet seeing your young child’s hair fall out could come as a real shock.

Hair loss isn’t uncommon in kids, but its causes may be different from those of adult-onset baldness. Often, children lose hair because of a scalp disorder.

Many of the causes aren’t life-threatening or dangerous. Still, losing hair can take a toll on a child’s emotional well-being. It’s hard enough to go bald when you’re an adult.

Because hair loss may have a profound psychological effect on kids, it’s important to see a doctor for treatment.

Often, hair loss in children is caused by an infection or other problem with the scalp. Here are some of the most common causes.

Tinea capitis

This scalp infection spreads when kids share personal items such as combs and hats. It’s also known as ringworm of the scalp, although it’s caused by a fungus.

Kids with tinea capitis develop patches of hair loss with black dots where the hair’s broken off. Their skin may turn red, scaly, and bumpy. Fever and swollen glands are other possible symptoms.

A dermatologist can diagnose tinea capitis by examining your child’s scalp. Sometimes the doctor will scrape off a tiny piece of the infected skin and send it to a lab to confirm the diagnosis.

Tinea capitis is treated with an antifungal drug taken by mouth for about eight weeks. Using an antifungal shampoo along with oral medication will prevent your child from spreading the virus to other kids.

Alopecia areata

Alopecia is an autoimmune disease that causes hair loss. Your immune system attacks the follicles from which hair grows. About 1 out of every 1,000 children has the localized version called alopecia areata.

Alopecia comes in different forms, depending on the pattern of hair loss:

children with alopecia areata may become totally bald. Some lose the hair on their body, too.

Doctors diagnose alopecia areata by examining your child’s scalp. They may remove a few hairs to examine under a microscope.

There’s no cure for alopecia areata, but some treatments can help regrow hair:

  • corticosteroid cream, lotion, or ointment
  • minoxidil
  • anthralin

With the right treatment, most kids with alopecia areata will regrow hair within one year.

Trichotillomania

Trichotillomania is a disorder in which kids compulsively pull out their hair. Experts categorize it as a form of obsessive-compulsive disorder. Some kids pull their hair as a kind of release. Others don’t realize they’re doing it.

Kids with this condition will have patchy areas of missing and broken hair. Some children eat the hair they pull and can develop big balls of undigested hair in their belly.

The hair will grow back once children stop pulling it out. Cognitive behavioral therapy teaches kids to become more aware of the hair pulling. This therapy helps them understand the emotions that trigger the behavior so they can stop it.

Telogen effluvium

Telogen is the part of the normal hair growth cycle when hairs stop growing and rest. Then, old hairs fall out to allow new ones to grow in. Normally, only 10 to 15 percent of hair follicles are in this phase at any one time.

In kids with telogen effluvium, many more hair follicles go into the telogen phase than normal. So instead of losing 100 hairs a day like usual, kids lose 300 hairs a day. The hair loss may not be noticeable or there may be bald patches on the scalp.

Telogen effluvium usually happens after an extreme event, such as:

  • very high fever
  • surgery
  • intense emotional trauma, such as the death of a loved one
  • severe injury

Once the event has passed, the child’s hair should grow back. Full regrowth can take six months to a year.

Nutritional deficiency

Good nutrition is essential for a healthy body. When kids don’t get enough vitamins, minerals, and protein, their hair can fall out. Hair loss can be a sign of eating disorders like anorexia and bulimia, as well as a side effect of a low-protein vegetarian or vegan diet.

A lack of these nutrients can contribute to hair loss:

Too much vitamin A can also lead to hair loss.

Your child’s pediatrician can suggest a healthy eating plan or prescribe a supplement to make up for the nutritional shortfall.

Hypothyroidism

The thyroid is a gland in your neck. It releases hormones that help control your body’s metabolism.

In hypothyroidism, the thyroid doesn’t make enough of the hormones it needs to function properly. Symptoms include:

  • weight gain
  • constipation
  • tiredness
  • dry hair or hair loss all over the scalp

Hair loss should stop when your child is treated with thyroid hormone medication. But it can take a few months for all of the hair to regrow.

Chemotherapy

Children who receive chemotherapy treatment will lose their hair. Chemotherapy is a strong medication that kills quickly dividing cells in the body — including cells in the hair roots. Once the treatment’s finished, your child’s hair should grow back.

Sometimes, children lose their hair for reasons that aren’t medical. Common causes include:

Newborn hair loss

During their first six months of life, most babies will lose the hair they were born with. The newborn hair falls out to make way for mature hair. This type of hair loss is perfectly normal and nothing to worry about.

Friction hair loss

Some babies lose hair in the back of their scalp because they rub their head repeatedly against the crib mattress, floor, or something else. Children outgrow this behavior as they become more mobile and start sitting and standing. Once they stop rubbing, their hair should grow back.

Chemicals

Products used to bleach, dye, perm, or straighten the hair can contain harsh chemicals that damage the hair shaft. Try to avoid using these products for young children or ask your hairstylist for recommendations on nontoxic versions made for kids.

Blow-drying

Excess heat from blow-drying or straightening can also damage hair and cause it to fall out. When drying your child’s hair, use a low heat setting. Don’t blow it dry every day to minimize heat exposure.

Hair ties

Pulling your child’s hair back into a tight ponytail, braid, or bun causes trauma to the hair follicles. Hair can also fall out if your child brushes or combs it too hard. Be gentle when combing and styling your child’s hair and keep ponytails and braids loose to prevent hair loss.

Losing hair can be upsetting for anyone, at any age. But it can be especially traumatic for a child.

Explain to your child why the hair loss happened and how you plan to fix the problem. If it’s the result of a treatable disease, explain that their hair will grow back.

If it’s not reversible, find ways to conceal the hair loss. You might try a:

  • new hairstyle
  • wig
  • hat
  • scarf

Get help managing hair loss from your child’s pediatrician, as well from as a hairstylist trained to work with kids who’ve lost their hair. If you need help paying for a wig, contact an organization such as Locks of Love or Wigs for Kids for help.

Counseling can also help kids cope with hair loss. Ask your pediatrician to recommend a counselor or therapist who can help talk your child through the experience.

Often, hair loss isn’t serious or life-threatening. The greatest impact is sometimes on your child’s self-esteem and emotions.

Treatments for hair loss in children are available but it can take some trial and error to find the right one. Work with your child’s medical team to come up with a solution that helps your child look — and feel — better.