PETALING JAYA: While hair loss is often associated with ageing or adult health issues, dermatologists warn that an increasing number of children are being affected, yet many parents remain unaware of the signs or underlying causes.
From fungal infections and tight hairstyles to nutritional deficiencies, the causes vary, but experts say the message is clear: early diagnosis is essential.
“Hair loss in children is typically caused by scalp-related conditions rather than hormonal imbalances,” said Columbia Asia Hospital Setapak consultant dermatologist Dr Elizabeth Chang Wei Hsi.
“The most common culprit is tinea capitis, a contagious fungal infection that causes scaly patches and broken hairs. We also frequently see alopecia areata, an autoimmune condition resulting in smooth, round bald spots, traction alopecia from overly tight hairstyles and trichotillomania, where children compulsively pull their own hair.”
Chang added that inflammatory scalp conditions such as eczema, seborrhoeic dermatitis and psoriasis can also lead to temporary hair shedding.
Another often overlooked condition is telogen effluvium, diffuse hair loss triggered by stress or illness.
“Most of these issues are treatable, and early diagnosis is crucial for effective management and preventing permanent hair loss,” she said.
Nutritional deficiencies are another key contributor.
“Iron and vitamin D deficiencies are among the most common causes, especially in cases of diffuse hair shedding,” Chang said.
“Even without anaemia, low iron stores can lead to hair loss, particularly in children with poor diets or adolescent girls experiencing heavy menstrual bleeding. Vitamin D, which supports hair follicle health, is also a concern due to reduced sun exposure.”
Central Dermatology Specialist Clinic consultant dermatologist Dr Meera Kuppusamy agreed that early detection is critical, especially for progressive conditions.
“Prompt diagnosis prevents worsening, particularly with tinea capitis, which is highly contagious, and traction alopecia, which can cause irreversible damage if ignored,” she said.
Meera noted a growing number of alopecia areata cases in younger children.
“In our clinical experience, alopecia areata in children under five often presents more aggressively and can be harder to treat. The psychological impact is also deeper for both the child and their parents.”
On treatment, she advocated a cautious, tailored approach.
“We typically begin with topical treatments such as corticosteroids or minoxidil, depending on the diagnosis. With children, we’re mindful of their sensitive skin and developing immune systems.
“Oral medications are only considered in severe or resistant cases, and are used under strict monitoring.”
Traction alopecia, linked to tight hairstyles, is also becoming more prevalent.
“It’s more common now, especially among girls who regularly wear tight braids, buns or ponytails. It’s often influenced by beauty trends and school grooming policies,” Meera said.
“Education on proper hair care is essential.”
Both dermatologists highlighted delays in parents seeking treatment.
“While many Malaysian parents are open to early intervention, lack of awareness, stigma, financial concerns and accessibility still hinder timely diagnosis,” Chang said.
Meera also agreed with this view.
“Awareness is still low. In some communities, children’s hair loss is even seen as taboo.
“Many parents resort to home remedies or non-medical advice rather than seeking professional help. Early dermatological evaluation should be encouraged,” she said.
They also stressed the importance of psychological support.
“Counselling can help build resilience, develop coping skills and reduce emotional stress,” said Chang.
“It’s a vital part of the healing process for both the child and the family.”
For parents unsure whether their child’s hair loss is a cause for concern, Meera had one key message:
“Any noticeable patchy or excessive hair loss warrants medical attention. Don’t wait, and don’t rely solely on the internet. Early intervention can make all the difference.”
