Baby hair loss on the top of the head is almost always normal. Most newborns lose some or all of their birth hair during the first six months of life, and the pattern often starts at the crown or along the front and temples. This shedding is driven by the same hormonal shift that happens after pregnancy, and the hair grows back on its own.
That said, a few less common causes can look similar and are worth knowing about so you can tell the difference.
Why Newborns Shed Their First Hair
In any healthy scalp, about 85% of hair follicles are actively growing at any given time, while roughly 15% are in a resting phase. At the end of the resting phase, a new hair pushes the old one out. In newborns, a sharp drop in circulating hormones after birth can push a much larger percentage of follicles into the resting phase all at once. When those resting hairs fall out weeks later, the result is noticeable thinning or bald patches rather than the invisible, gradual shedding adults experience daily.
Research on newborn scalps has identified two common patterns. A less common “neonatal type” appears in the first four weeks and follows a frontal-temporal pattern, meaning hair thins along the forehead and sides. A more frequently observed “classic type” shows up around 8 to 12 weeks and is concentrated at the back of the head. Both resolve without treatment, typically within six to nine months.
Friction From Sleeping and Lying Down
If the bald spot is on the back or top of your baby’s head, friction is a likely contributor. Between 3 and 6 months old, babies spend a lot of time on their backs in cribs, car seats, bouncers, and activity mats. Repeated head-turning against these firm surfaces rubs hair away in a localized patch. You’ll often see this as a smooth, flat spot that matches where your baby’s head rests most.
This type of hair loss resolves once your baby starts sitting up and spending less time on their back. Regrowth can take 6 to 12 months from that point, so the patch may stick around for a while even after the cause is gone. No treatment is needed.
Cradle Cap and Flaky Patches
Cradle cap (infantile seborrheic dermatitis) causes yellow or white, waxy, fish-scale-like patches that stick to the scalp. When those crusty patches eventually flake off, they can pull a few hairs with them, creating the appearance of thinning in that area. The scalp underneath isn’t damaged, and the hair grows back.
If your baby has cradle cap, washing their hair once a day with a gentle baby shampoo and loosening the scales with a small, soft-bristled brush before rinsing can help clear it up. Once the scales are gone, you can drop back to washing two or three times a week to prevent buildup. Avoid picking at the scales with your fingernails, which can irritate the skin.
Less Common Causes Worth Knowing
Fungal Infection (Ringworm of the Scalp)
Tinea capitis is a fungal infection that can cause patchy hair loss in children. Unlike normal shedding, it comes with visible skin changes: red, swollen patches, dry scaly rashes, and itching. One telltale sign is hair that breaks off right at the scalp surface, leaving tiny black dots. In more severe cases, a painful, swollen lump called a kerion can form, sometimes oozing pus or developing crusty blisters. This needs treatment and won’t resolve on its own.
Alopecia Areata
This autoimmune condition causes the body’s immune system to mistakenly target hair follicles. It looks different from normal baby shedding: you’ll see round, well-defined smooth patches that develop over a few weeks. The skin in the bald area feels soft and smooth with no redness, flaking, or irritation. Under close inspection, some hairs at the edges of the patch look tapered, thicker at the tip and thinner where they meet the scalp. These “exclamation point hairs” are a hallmark of the condition. Alopecia areata is uncommon in infants but not impossible.
Nutritional and Metabolic Causes
Rarely, hair loss in an infant can signal a metabolic condition like biotinidase deficiency, a genetic disorder that prevents the body from recycling biotin (a B vitamin essential for processing proteins, fats, and carbohydrates). This condition is screened for at birth in most countries through the standard newborn blood spot test. If your baby had normal newborn screening results, this is very unlikely to be the cause.
How to Tell Normal Shedding From a Problem
Normal newborn hair loss has a few recognizable features. The scalp looks healthy: no redness, no scales (beyond mild cradle cap), no swelling, no broken hairs at the surface. The thinning is diffuse or follows a pattern that matches where your baby’s head rests. Your baby isn’t itching or bothered by it, and there are no other symptoms.
Signs that something else may be going on include:
- Red, swollen, or scaly skin in the areas of hair loss
- Hairs that break off at the surface rather than falling out cleanly
- Sharp, round bald patches with completely smooth skin
- Pus, crusting, or painful lumps on the scalp
- Hair loss that continues past 12 months without regrowth
Any of these warrant a visit to your pediatrician or a referral to a pediatric dermatologist. In particular, a scalp infection with severe inflammation or a kerion needs prompt treatment to prevent permanent hair loss in that area.
What You Can Do in the Meantime
For normal shedding, there’s nothing you need to do except wait. The new hair that grows in may be a completely different color or texture than the birth hair, which is normal. A few practical steps can minimize friction-related loss: give your baby supervised tummy time during the day, rotate which end of the crib you place their head, and use smooth, soft crib sheets. Avoid headbands, tight hats, or anything that pulls on fine baby hair.
Gentle scalp care helps too. Washing with a mild baby shampoo a few times a week keeps the scalp clean without stripping oils. A soft-bristled brush can stimulate circulation and feels good to most babies. Skip any products marketed as hair growth treatments for infants. They’re unnecessary and can irritate sensitive skin.