Hair Loss in Children

My three-year-old niece is losing clumps of hair. Her pediatrician says it's normal for a child her age. What could be causing this problem?

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

Hair loss in children understandably causes great distress in both the child and parents. Three diseases account for most hair loss in children: alopecia areata, tinea capitis, and trichotillomania.

• Alopecia areata - This is the most common cause of hair loss in children. This is felt to be caused by the body's immune system reacting at the site of hair growth. Often no treatment is needed because 60% of these children will have total hair regrowth within 12 months.
There has been some success with use of medications that suppress the immune system, but the side-effects may outweigh the benefits for a disease that will probably resolve on its own. Rarely, an entity known as alopecia universalis may cause total hair loss including eyelashes and eyebrows.

• Tinea capitis (ringworm) - This fungal infection is common in children, particularly toddlers and early schoolaged children. This disease is not the result of a dirty environment. This infection gets into the hair roots, therefore, treatment consists of oral medications as well as a shampoo, both of which should be continued for at least three weeks.

• Trichotillomania - This is a fancy word for "pulling out the hair". This is generally considered to be a nervous habit and may include the pulling of eyebrows and eyelashes. Oiling the hair may make it more difficult to pull it out, but addressing the underlying cause of nervousness is the key.

I suggest you have your niece seen by her physician who will examine the hair and follicles for evidence of infection, pulling of the hair, or discreet islands of hair loss suggestive of alopecia areata.

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