Is Your Child Sick? TM

Hair Loss

Is this your child's symptom?

  • Hair loss in patches or throughout the scalp
  • The missing hairs can be broken off or just fall out
  • The medical term for hair loss is alopecia

Causes

Common causes of hair loss are listed below. Most don't usually require medical treatment.

  • Ringworm of the Scalp. This is the main cause of patchy hair loss that needs medical treatment. Your child's doctor will prescribe a medicine to treat ringworm of the scalp. It's taken by mouth.
  • Newborn Hair Loss. The hair of many newborns falls out during the first few months of life. This baby hair is replaced by permanent hair.
  • Rubbing or Friction. Babies can rub off a patch of hair on the back of the head. This most commonly occurs in infant 3 to 6 months old. It is a result of friction during head-turning against a firm surface. Examples are crib mattresses, playpens, and infant seats. The hair grows back once the baby starts sitting up. Also called friction alopecia or pressure alopecia. Repeated or severe friction can cause hair loss at any age.
  • Tight Hair Styles. If hair is pulled too tight, it will eventually break. Mostly seen with tight braids, pony tails or dreadlocks (especially corn row styles). Hair can also be lost because of vigorous hair-brushing or back combing. Hot hairstyling tools can also cause hair damage. Also known as traction alopecia, mechanical alopecia, or "hair abuse."
  • Twisting or Pulling Out the Hair. This is a nervous habit called trichotillomania. Frequent twisting of the hair results in broken hairs of different lengths. The missing hair occurs in patches of different shapes. This creates bald spots. Rarely, it can include plucking of the eyebrows or eyelashes. Can occur with nail biting, lip biting or sucking, and sore picking habits. In older children, may be associated with OCD.
  • Stress. Hair follicles are very sensitive to physical or emotional stress. The hair begins to fall out about 3-4 months after a severe stress. Reason: Hair follicles are very sensitive to physical or emotional stress. Examples are a high fever, severe illness or surgery. Also, a psychological crisis or a crash diet can be triggers. In pregnant teens, the stress can be childbirth. After hair stops shedding, the hair will slowly grow back. This can take 6 to 8 months for all the hair to grow back. The whole cycle takes about 12 months. This type of hair loss is called telogen effluvium.

When to Call for Hair Loss

Call Doctor Now or Go to ER

  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Scalp is red and very swollen in area of hair loss
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Scabs or crusts are present in the hair
  • Ringworm of the scalp suspected. (Round patch of hair loss with scales, rough surface, redness or itching)
  • Broken hairs from tight hair style and pimples are present in scalp
  • Patch of hair loss and cause not known
  • Widespread hair thinning and cause not known
  • Hair loss from nervous habit of twisting the hair (needs counseling)
  • Hair loss is a chronic problem
  • Normal hair loss suspected, but doesn't grow back within 6 months
  • You have other questions or concerns

Self Care at Home

  • Newborn normal hair loss in infancy
  • Hair loss on back of head from chronic rubbing and friction
  • Hair loss from tight hair style
  • Widespread hair thinning follows a major stress about 3 months ago

Call Doctor Now or Go to ER

  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Scalp is red and very swollen in area of hair loss
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Scabs or crusts are present in the hair
  • Ringworm of the scalp suspected. (Round patch of hair loss with scales, rough surface, redness or itching)
  • Broken hairs from tight hair style and pimples are present in scalp
  • Patch of hair loss and cause not known
  • Widespread hair thinning and cause not known
  • Hair loss from nervous habit of twisting the hair (needs counseling)
  • Hair loss is a chronic problem
  • Normal hair loss suspected, but doesn't grow back within 6 months
  • You have other questions or concerns

Self Care at Home

  • Newborn normal hair loss in infancy
  • Hair loss on back of head from chronic rubbing and friction
  • Hair loss from tight hair style
  • Widespread hair thinning follows a major stress about 3 months ago

Care Advice

Newborn Normal Hair Loss in Infancy

  1. What You Should Know About Newborn Normal Hair Loss:
    • Newborns are born with varying amounts of hair.
    • The baby hair of many newborns falls out during the first 6 months of life. Hair loss peaks at 3 months old. The mother may also lose some of her hair at this time.
    • This baby hair is then replaced by permanent hair.
    • The normal hair comes in between 6 and 12 months.
    • This shedding phase in newborns is always normal.
    • Hair loss is not caused by shampoos.
  2. Call Your Doctor If:
    • Hair does not grow back by 12 months old
    • You have other questions or concerns

Hair Loss on Back of Head From Chronic Rubbing and Friction

  1. What You Should Know About Rubbing Off Hair on Back of Head:
    • Babies can rub off a patch of hair on the back of the head. This most commonly occurs in infant 3 to 6 months old.
    • The hair loss is from friction during head-turning against a firm surface. Examples are crib mattresses, playpens, activity mats and infant seats.
    • The hair grows back once the baby starts to sit up.
    • This may take 6 to 12 months.
    • Can also occur in any bedridden child (e.g., severe cerebral palsy).
  2. Treatment for Hair Loss from Friction and Too Much Time on Back:
    • After 1 month old, give your baby more tummy time.
    • Caution: Tummy time should always occur under adult supervision. Reason: Risk of suffocation until child reaches an age when can turn over.
    • Tummy time has many benefits.
    • It will help the back of head become more rounded and less flat.
    • It will also build up strength in shoulder muscles.
  3. Call Your Doctor If:
    • Hair does not grow back by 6 months after learning to sit
    • You have other questions or concerns

Hair Loss From Tight Hair Style

  1. What You Should Know About Hair Loss from Tight Hair Style:
    • Symptoms: Broken hairs are seen at the hairline or where the hair is parted. It's usually the same on both sides of the head.
    • Cause: If hair is pulled too tight, it will eventually break. This gives a frizzy look from hairs broken off at various lengths.
    • Examples: It's most commonly seen with tight braids, pony tails or dreadlocks. Hair can also be lost because of vigorous hair-brushing or back combing. Hot hairstyling tools can also cause hair damage. Can also occur during exercise while wearing head phones.
    • Hair loss is not caused by shampoos.
  2. Treatment of Broken Hairs from Tight Hair Style:
    • Change the hair style to one that doesn't put tension on the hair.
    • If that is not acceptable, loosen the ponytail or braids.
    • These hair styles are at risk if they feel tight or cause any pain.
    • Outcome: If tight hair styles are avoided, the hair will return to normal.
    • Warning: If tight braiding continues over 10 years, permanent hair loss can occur.
  3. Pimples in the Hair and on the Scalp:
    • Cause: Most pimples are caused by blocked hair follicles.
    • Treatment: Stop using any ointments or oils in the hair. Reason: they block the hair follicles.
    • Stop any hair style that puts tension on the hair. Reason: damages the hair follicle and makes it prone to infection.
    • Wash any ointment or greasy pomade off the scalp with soap and water.
    • Antibiotic Cream: Apply an antibiotic cream to the pimples. Do not use ointment. Use it 2 times a day for 3 days. No prescription is needed.
    • Outcome: Most pimples will clear up in 3 days.
  4. Call Your Doctor If:
    • Hair does not grow back by 6 months after hair style changed
    • You have other questions or concerns

Widespread Hair Thinning Following Major Stress About 3 Months Ago

  1. What You Should Know About Hair Loss after Stress:
    • Symptoms: Lots of hair is noticed in a comb or brush. The hair falls out from all parts of the scalp. This leads to major thinning of the hair, but no bald spots.
    • Cause: Severe stressful event. Hair follicles are very sensitive to physical or emotional stress. Examples are a high fever, severe illness or surgery. Also, a psychological crisis or a crash diet can be triggers. In pregnant teens, the stress can be childbirth. Hair loss is not caused by shampoos.
    • Time Frame: The hair begins to fall out about 3-4 months after a severe stress. It continues to fall out excessively over the next 3 or 4 months. After hair stops shedding, the hair will slowly grow back. This can take 6 to 8 months for all the hair to grow back. The whole cycle takes about 12 months.
    • There's no way to hurry the process. The hair growth cycle needs to run its course.
    • Here is some care advice that should help.
  2. Hair Care:
    • Treat the hair gently.
    • Wash the hair no more than once per day. Always use a hair conditioner.
    • Comb the hair rather than brushing it.
    • Be careful at combing out any tangled hair.
    • Avoid any tight hair styles such as braids or a pony tail.
    • Don't put tension on the hair.
    • No special shampoo or cream is needed or helpful.
  3. What to Expect:
    • No more than 50% of the hair will be lost.
    • Once it starts to regrow, all the hair will grow back in about 6 months.
    • The new hair will look normal.
  4. Call Your Doctor If:
    • Hair does not grow back by 12 months after stressful event
    • You have other questions or concerns

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Copyright 1994-2017 Schmitt Pediatric Guidelines LLC. All rights reserved.


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