Sometimes children have bald patches on the scalp due to hair loss. Many babies are bald from birth, or lose their hair shortly afterwards, which is a normal pattern before permanent hair growth occurs. Often babies have a bald patch at the back or side of the scalp due to friction caused by lying on the mattress of their cot or in baby seats. This is also normal and as soon as the baby is able to spend more time sitting up, hair starts to grow back in these bald patches.
The commonest cause of abnormal hair loss is ringworm. In rare cases, older children may pull out their hair (trichotillomania) and this usually signifies some emotional disturbance. If there is no identifiable cause for hair loss, your child may be suffering from alopecia areata, which is hair loss that runs in families. In this case hair may be lost from any part of the body.
If your child has ringworm or impetigo, he may complain of an itchy scalp. Otherwise the only sign of alopecia is a bald patch.
It is important to remember not to overdo it with brisk hairbrushing and very tight pigtails or ponytails, as this can sometimes cause minor hair loss.
When to see your doctor
• if your child has significant hair loss for no apparent reason;
• if your child has an itchy scalp;
• if in addition to hair loss your child is generally unwell.