What are the causes of hair loss in children and teenagers?

The problem of excessive hair loss in children and adolescents is gaining importance in trichology and medical practices year after year. Until recently, hair loss was associated primarily with adult patients and the aging process. Today, it is increasingly common in the specialist’s chair in PT CLINIC are teenagers, and even school-aged children and preschoolers. As a clinic specializing in the comprehensive treatment of scalp and hair conditions, under the supervision of Piotr Turkowski, MD, PhD We fully understand that hair loss at a young age is more than just an aesthetic issue. Above all, it is a clinical sign of systemic disorders, which places a significant psychological and emotional burden on a young person.

In this comprehensive guide, we will explain the medical causes of hair loss in children and adolescents, how the issue differs between girls and boys, what the professional diagnostic process entails, and the modern, safe therapies offered by contemporary aesthetic medicine and trichology.

Why do children and teenagers experience hair loss?

In young people, the hair growth cycle (anagen, catagen, telogen) should remain stable. When this cycle is disrupted, it most commonly involves a sudden transition of a large number of hairs from the growth phase to the resting and shedding phase (known as telogen effluvium), or processes that damage the hair follicles (anagen effluvium or scarring alopecia).

The bodies of children and adolescents are growing dynamically, which means there is a tremendous demand for micronutrients, energy, and a stable hormonal balance. Any disruption to metabolic or immune equilibrium—even one that seems trivial—can have an immediate impact on the condition of hair follicles.

Hair loss in teenage girls

In a trichology clinic, teenage patients make up a very large group. The causes of hair loss in adolescent girls are varied, but they can be divided into several main clinical categories:

• Restrictive diets and caloric deficits: The pressure of beauty standards and the desire for rapid changes in body shape often lead teenagers to resort to fasting, elimination diets, or selective eating. A drastic reduction in protein intake—protein being the primary building block of hair (keratin)—combined with an energy deficit, causes the body to divert resources away from non-essential tissues, such as hair and nails, in order to prioritize the needs of internal organs.
• Severe iron and ferritin deficiencies: With the onset of menstruation, adolescent girls begin to lose iron. Low levels of ferritin (an iron-storage protein) are among the most common causes of diffuse hair thinning (telogen effluvium) in young women. It is worth noting that standard laboratory reference ranges for ferritin are often too broad; for healthy hair growth, levels should ideally be above 40–50 ng/ml.
• Vitamin D3 deficiency: In our geographical latitude, almost every teenager suffers from a deficiency in cholecalciferol (vitamin D3). Vitamin D3 plays a crucial role in stimulating the proliferation of stem cells within the hair follicle.
• Endocrine disorders: The onset of a “hormonal storm” involving sex hormones can trigger latent predispositions toward polycystic ovary syndrome (PCOS) or reveal early thyroid issues (such as autoimmune thyroiditis—Hashimoto’s disease), both of which directly contribute to hair miniaturization.

Scalp microbiome and common skincare mistakes among adolescents

Puberty is characterized by the rapid activation of sebaceous glands, driven by androgens. Excessive sebum production (seborrhea) creates an ideal environment for the overgrowth of *Malassezia* yeasts, which naturally inhabit the scalp.

When sebum oxidizes and accumulates in the openings of hair follicles, it leads to the development of inflammation, oily dandruff, and seborrheic dermatitis of the scalp. Inflammation around the hair follicle weakens its anchorage, resulting in both mechanical and biological hair loss.

The most common skincare mistakes made by teenagers:

• Washing the hair too infrequently out of fear that it will “fall out during washing” (hair that sheds while washing is already in the telogen phase; infrequent washing actually exacerbates inflammation).
• Using harsh, mass-market anti-dandruff shampoos containing strong detergents like SLS/SLES, which damage the skin’s hydrolipid barrier.
• Straightening hair daily—sometimes even multiple times a day—without using heat-protectant products, which leads to thermal destruction of the hair shaft (causing so-called “bubble hair”) and breakage right at the scalp.
• Wearing tight hairstyles (such as ponytails or buns), which exert constant mechanical stress and can lead to traction alopecia.

Hair loss in teenage boys

For boys, the issue presents somewhat differently. When a teenager seeks help for thinning hair, it most commonly affects the temporal regions (a receding hairline and “temple points”) as well as the crown (the vertex). This is the classic clinical presentation of androgenetic alopecia.

Although it is commonly believed that androgenic alopecia affects men in their thirties or forties, in individuals with a strong genetic predisposition, the process can begin very early—as early as adolescence (between the ages of 15 and 18). The hypersensitivity of hair follicles to dihydrotestosterone (DHT)—a derivative of testosterone—leads to the gradual miniaturization of the follicle. With each successive growth cycle, the hair becomes thinner and shorter, until the follicle eventually undergoes complete fibrosis.

Professional diagnostics at PT CLINIC

At PT CLINIC, the treatment process is never based on guesswork. Every patient—regardless of age—undergoes a thorough diagnostic pathway, which includes:

• Detailed medical and family history: We analyze diet, stress levels, lifestyle, family medical history, and current medications.
• Trichoscopy (digital videodermoscopy): A non-invasive optical examination of the scalp and hair, performed under high magnification. It allows the physician to assess the condition of hair follicle openings, hair shaft thickness, the presence of “miniaturized” hairs, signs of inflammation, and the degree of scalp vascularization.
• Targeted laboratory diagnostics: Based on the medical history, we order blood tests to rule out hormonal imbalances, deficiencies in iron, ferritin, vitamin D3, or vitamin B12, as well as immunological disorders.

Effective treatment methods and in-office therapies for adolescents

Once an accurate diagnosis has been made, a specialist develops an individualized therapeutic plan. For adolescents, we prioritize safe, non-invasive methods with proven clinical efficacy:

• Targeted at-home care and specialized products: Incorporating professional acid or enzymatic scalp exfoliators (used once a week), sebum-regulating shampoos, and customized scalp treatments—such as lotions and ampoules—rich in peptides and anti-inflammatory agents.
• Scalp needle mesotherapy: A procedure involving the superficial injection of nutrients, amino acids, vitamins, and biomimetic peptides into the scalp, which stimulate dormant hair follicles to grow and improve microcirculation.
• Oxygen infusion: A non-invasive method of delivering pure hyperbaric oxygen, combined with nourishing cocktails, into the deep layers of the epidermis. The treatment provides a powerful oxygenating effect, acts as an antibacterial agent, and soothes an irritated scalp.
• LED light therapy: The use of light at specific wavelengths to stimulate cellular metabolism (ATP production in the mitochondria), inhibit inflammation, and accelerate the regeneration of hair follicles.
• Medication under medical supervision: In appropriate cases (e.g., advanced androgenic alopecia in older adolescents), a physician may prescribe safe topical treatments that inhibit the miniaturization of hair follicles.

Other, less common causes of hair loss in children

Among young patients, we also encounter medical conditions with specific underlying causes:

• Alopecia Areata: An autoimmune condition in which the patient’s immune system identifies its own hair follicles as antigens, triggering inflammation around them. It manifests as the sudden appearance of smooth, round patches completely devoid of hair. This condition requires close collaboration between a trichologist and a dermatologist, as well as the implementation of specialized topical or systemic treatment.
• Trichotillomania: An impulse-control disorder of psychogenic origin. It involves the conscious or unconscious pulling out of one’s own hair (from the scalp, eyebrows, or eyelashes) as a means to reduce emotional tension and stress. In such cases, while scalp restoration at PT CLINIC is important, the primary need is for psychological or psychotherapeutic support for the young patient.

Guidelines for Proper At-Home Care for Teenagers

To support the treatment process received in a professional setting, teenagers should follow a few essential rules for their daily hair and scalp hygiene:

1. Regular exfoliation: Use an enzymatic scalp scrub once a week before washing your hair to remove dead skin cells and excess sebum.
2. Washing frequency: Wash your hair as often as your scalp requires—even daily or every other day—using gentle shampoos formulated for sensitive or oily scalps.
3. The secret to proper washing: Lather the shampoo in your hands, apply it to your scalp (not the lengths of your hair!), and gently massage with your fingertips. Leave the lather on for 2–3 minutes, then rinse thoroughly. It is a good idea to repeat this process twice.
4. Thermal protection: Limit the use of straighteners and curling irons. If you do use them, always apply a professional heat-protectant product and set the device to the lowest possible temperature.
5. Proper drying: Never go to bed with a wet or damp head (this encourages the growth of fungi). Dry your hair using a hairdryer with a cool (not hot) airflow.