Almost all newborns lose some or all of their hair. This is normal and to be expected. The baby hair falls out before the mature hair comes in. So hair loss occurring in the first six months of life is not a cause for concern.
Very commonly, a baby loses her hair where she rubs her scalp against the mattress or as a result of a head banging habit. As she starts to move more and sit up or outgrow this head rubbing or banging behavior, this type of hair loss will correct itself.
Many babies also lose hair on the back of the scalp at age four months as their hair grows at varying times and rates. In very rare cases, babies may be born with alopecia (hair loss), which can occur by itself or in association with certain abnormalities of the nails and the teeth. Later in childhood, hair loss may be due to medications, a scalp injury, or a medical or nutritional problem.
An older child may also lose her hair if it’s braided too tightly or pulled too hard when combing or brushing. Some children (under age three or four) twirl their hair as a comforting habit and innocently may pull it out. Other children (usually older ones) may pull their hair out on purpose but deny doing so, or they simply may be unaware that they are doing it; this often is a signal of emotional stress, which you should discuss with your pediatrician.
Alopecia areata, a condition common in children and teenagers, seems to be an “allergic” reaction to one’s own hair. In this disorder, children lose hair in a circular area, causing a bald spot. In general, when it’s limited to a few patches, the outlook for complete recovery is good. But when the condition persists or worsens, steroid creams and even steroid injections and other forms of therapy at the site of the hair loss often are used. Unfortunately, if the hair loss is extensive, it may be difficult to renew its growth.
Because alopecia and other types of hair loss can be a sign of other medical or nutritional problems, bring these conditions to your pediatrician’s attention whenever they occur after the first six months of age. The doctor will look at your child’s scalp, determine the cause, and prescribe treatment. Sometimes, a referral to a pediatric dermatologist is necessary.