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Hair loss is a very common problem among adults who are above 50. But did you know that hair loss is common among children too? Yes, hair loss in children aged 12 years and younger are most often caused due to a benign or self-limiting condition  .
The structure, appearance and type of hair differ according to ethnic groups and region. These factors may also have an impact on the pattern of hair loss  .
A single strand of hair takes about 2-6 years to grow, which is called the anagen phase. This phase is followed by the catagen phase (2-3 weeks), which is a short transition phase that indicates the end of active hair growth. The next stage is the telogen phase where the hair goes into a rest period and lasts for 2-4 months before the hair falls off and new hair grows.
While 90% of the hair follicles are in anagen phase, 10-14% are in telogen and 1-2% in catagen. And the phases of hair follicles may differ in different parts of the body.
Causes Of Hair Loss In Children
Hair loss or alopecia in children, can be due to various factors which are different from adult-related hair loss problems. These causes are as follows:
1. Telogen effluvium 
It is a temporary hair loss problem that occurs after the child has had a physical or emotional problem, such as fever or infection, physical injuries, emotional stress, and vitamin imbalances.
Children with telogen effluvium lose their hair more than what they normally lose in the telogen phase. So instead of losing 100 strands of hair a day, children in this phase may lose up to 300 strands of hair a day.
In most cases, the hair grows back over time which can take 6 months to 1 year.
2. Tinea capitis 
Tinea capitis, also known as scalp ringworm is a common, contagious fungal infection that causes a red, ring-shaped rash on the skin of the scalp. The symptoms are itchy and irritated skin, fever and swollen glands.
Diagnosis is done by scraping off a tiny piece of the infected skin and sending it to the lab to confirm what exactly it is. Tinea capitis is usually treated with antifungal medications.
3. Traction alopecia 
It is a type of hair loss that occurs when your hair is going through extreme pressure, for example wearing very tight braids or having a tight ponytail for a long period. This leads to itchy, red scalp with large bald or thinning spots.
Traction alopecia can go away on its own once your hair goes through less pressure, but regrowing of the hair takes time.
4. Alopecia areata 
It is an autoimmune disease that occurs when the immune system starts attacking the hair follicles. It causes total baldness and children start to lose eyebrows and eyelashes.
Alopecia areata is of different types:
- Alopecia areata - bald patches develop on the child's scalp
- Alopecia totalis - all the scalp hair falls out.
- Alopecia universalis - all the body hair falls out.
There's no cure for this condition, but with the right treatment, regrowth of hair can be seen within 1 year.
5. Trichotillomania 
Children who keep playing or twirling their hair can damage the hair follicles, causing loss of hair. This usually occurs when people have anxiety or obsessive compulsive disorder. The symptoms of trichotillomania are patchy areas on the scalp and broken hair.
The treatment for trichotillomania is cognitive behavioural therapy and emotional support.
6. Nutritional deficiency 
When children miss out on essential nutrients like iron, zinc, biotin, niacin and protein, they tend to start losing hair. Nutritional deficiency can be caused due to eating disorders like bulimia and anorexia or a low-protein diet.
In addition, the other causes of hair loss in children are thyroid disorder, diabetes mellitus, anaemia, systemic lupus erythematosus, and structural abnormalities of the hair shaft.
When To See A Doctor
A child should seek medical treatment immediately if he or she has the following symptoms:
- An itchy or red scalp
- Loss of eyebrows and eyelashes
- Bald spots on the scalp
- Losing more hair than usual
- Scalp injury
As parents, you can talk to your child to cope with any kind of stress and help build their self-esteem. You can find ways to conceal the baldness by trying out a new hairstyle, or providing a wig, hat or a scarf to the child.
-  Cranwell, W., & Sinclair, R. (2018). Common causes of paediatric alopecia.Australian journal of general practice,47(10), 692.
-  Morand, J. J. (2008). Skin color, hair types and phenotype diversity: Races, ethnic groups and populations in the medical literature.
-  Harrison, S., & Sinclair, R. (2002). Telogen effluvium.Clinical and Experimental Dermatology: Clinical dermatology,27(5), 389-395.
-  Gupta, A. K., & Summerbell, R. C. (2000). Tinea capitis.Medical Mycology,38(4), 255-287.
-  SLEPYAN, A. H. (1958). Traction alopecia.AMA archives of dermatology,78(3), 395-398.
-  Madani, S., & Shapiro, J. (2000). Alopecia areata update.Journal of the American Academy of Dermatology,42(4), 549-566.
-  Hautmann, G., Hercogova, J., & Lotti, T. (2002). Trichotillomania.Journal of the American Academy of Dermatology,46(6), 807-826.
-  Goldberg, L. J., & Lenzy, Y. (2010). Nutrition and hair.Clinics in dermatology,28(4), 412-419.