It's natural for parents to become alarmed when they see locks of their babies hair falling out. Almost all newborns lose some (or all) of their hair during the first six months of life. This is a normal process. In most cases the hair eventually grows back, although the new hair may be a completely different color and texture than at birth!
A common condition, that may cause hair loss in infants is cradle cap. Cradle cap mainly affects infants between the ages of two to six months; causing a crusty, scaling scalp rash. Left untreated, cradle cap often clears up within several months. In severe cases it can cause itching and hair loss, and may also spread to other areas of the body.
Other forms of hair loss affecting infants are rare. They are often congenital in nature and may include hair shaft defects. As the child gets older they become more susceptible to various types of hair loss. After discussing the rare forms of hair loss which can affect infants and children, the more common forms will be addressed.
Congenital Atrichia
With congenital atrichia a child could be born with apparently normal hair; but once it enters the first resting period the hair falls out, and the entire growth process shuts down. In order for hair to grow, certain cells must stay in close contact with each other to transmit and receive signals necessary to keep the hair growth cycle functioning. With this condition the cellular communication gets disconnected, deactivating the hair growth cycle.
Loose Anagen Syndrome
This type of hair loss is most typical in small children with sparse fine hair that can easily be pulled out. It mostly affects girls with light hair. The hair usually does not grow past the nape of the neck. Under a microscope the hairs appear to lack an inner and outer root sheath and have a ruffled cuticle.
Triangular Alopecia
This is a pattern of hair loss that occurs in the temporal area on one or both sides and is usually in a triangular shape. The absence of hair in this area is present at birth or just after. It is permanent and irreversible but is not progressive. The shape and size of the bald area remains the same throughout lifetime.
Pili Torti
This condition can be congenital or acquired. It is most common in girls who have thin blonde hair. There is a rigid twisting of the hair fibers which leads to fractures in the cuticle and internal cortex layer of the hair shaft. The hair is dry and brittle and may stand out from the scalp. It breaks off at varying lengths.
Monilethrix
This is a rare condition that begins in infancy. Although the infant is born with what appears to be normal vellus hair, it is soon replaced with dry, brittle hair that has a beaded appearance. The hair often breaks off even with the scalp and seldom grows longer than 2.5 cm.
Uncombable Hair Syndrome
Children with this syndrome usually have silvery blonde glass-like hair that is unruly and won't lie flat. It is difficult or impossible to comb. Because of its appearance it is also called "spun-glass hair." The hair stands away from the scalp in a disorderly fashion. Microscopic evaluation reveals a triangular (or kidney bean) shaped hair shaft with longitudinal grooving. Spontaneous improvement is often seen in later in adolescence.
The following types of hair loss are common in children aged four and older.
Ringworm
Contrary to its name ringworm does not come from a worm but is caused by a type of fungus called dermatophyte. It is highly contagious and can be transmitted through other people or animals. It is mostly seen on children between 4 and 11 years old. It usually begins as a small pimple that becomes larger, leaving scaly patches of baldness with an outline shaped like a ring. The hair often becomes brittle and breaks off very close to the scalp causing what is referred to as "black dot alopecia." Ringworm is also referred to as tinea capitis.
Alopecia areata
Alopecia areata is a common autoimmune disorder which causes the hair to fall out in patches with well defined margins. The onset of alopecia areata is most common in children between four and seven years old but it can strike anybody at anytime. Alopecia areata can progress to alopecia totalis or alopecia universalis affecting total scalp and body hair.
Traction Alopecia
Traction alopecia occurs from sustained tension on the scalp due to tightly pulled hairstyles. Prolonged traction causes hair to loosen from its follicular roots. Cheerleaders, dancers and other children who routinely wear these types of hairstyles are at risk. Also at risk are those who wear hair extensions-which are becoming consistently more popular. Prolonged persistent traction can cause permanent hair loss.
Trichotillomania
Trichotillomania can be translated from Greek to mean a "manic desire to pluck out one's own hair." It is an impulse control disorder that often starts in childhood. A person with this disorder will feel an overwhelming urge to pull out his or her hair. This urge causes an extreme amount of tension which continues to build until the hair is pulled.
Telogen Effluvium
Telogen effluvium, also known as diffuse hair loss causes more hair than usual to retreat into the resting phase. This can be a reaction to any disturbance in the body as hair is very sensitive to changes. This type of hair loss is usually temporary and easily corrected once the problem is identified and addressed. Any type of illness, surgery or trauma can cause temporary diffuse hair loss.
Medications
Any medication can cause hair loss, even if it is not listed as a symptom. Psychopharmaceutical medications which are becoming more commonly prescribed to adolescents are known to cause hair loss in some people. Acne medications derived from vitamin A can cause hair loss. Some anti-fungal and anti-inflammatory medicines list hair loss as a side effect. Any hormonal medication such as birth control pills or steroids can cause hair loss.
Bacterial Infections
Certain bacteria and other microorganism can infect the scalp causing inflammation and hair loss. Hair loss from scalp infections may be temporary or permanent depending on the degree of damage.
Eating Disorders
Hair loss can be a symptom of any eating disorder such as anorexia nervous or bulimia.
Puberty
Hair loss often occurs during times of hormonal changes. Some hair loss may occur during puberty.
Immunizations
There have been reports of hair loss as an adverse side effect of vaccinations, mostly associated with the hepatitis B vaccine and mostly affecting females.
Hair Loss