Disorders of the hair and nails can cause a considerable amount of emotional distress and anxiety for both the child and family. Hair has significant psychosocial implications and children with hair disorders, particularly hair loss, are often subject to teasing at school. Accurate diagnosis and treatment are essential.

Telogen effluvium is the most common cause of hair loss in children and is often triggered by illness or other stressors. Similarly, onychomadesis or nail shedding most commonly occurs after severe illness. Both conditions are self-limited and discussion with parents about the favorable prognosis and eventual resolution suffices.

Alopecia areata may show spontaneous regrowth but many times parents and/or patients opt for treatment. Tinea capitis should be recognized early and treated with appropriate weight-based systemic antifungals. Intervention for head lice should be prompt so as to avoid epidemics in the classroom. Trichotillomania, categorized as an impulse control disorder, may also require treatment. This chapter will review common pediatric hair and nail conditions and discuss their management.