Do not blame yourself for your
child's hair pulling.
Accept that your child has
Trichotillomania, do not try
and avoid it.
Listen to your child and
Trichotillomania is the medical term for a condition that describes young children and adolescents who
pull out the hair from their scalp, eyelashes, eyebrows, or
other parts of the body, resulting in noticeable bald patches.
estimated to affect one to two percent of the population, or
four to eleven million Americans, and often begins in
childhood and adolescence.
the symptoms range greatly in severity, location on the body,
and response to treatment, most children with Trichotillomania
pull enough hair over a long enough period of time that they
have bald spots on their heads (or missing eyelashes,
eyebrows, etc.) pubic, or underarm hair),
Trichotillomania does not
cause permanent hair loss, harm to the hair follicles nor does
it cause brain damage. When the pulling, twisting or plucking
stops, the child's hair will grow back normally.
Trichotillomania is quite common in children and the behavior
responds well to treatment.
The main concern for the
physician diagnosing hair pulling is to rule out other
problems that may be related to the hair loss. Medical
conditions such as
alopecia areata and
tinea capitis should be ruled out. In addition, the
physician will want to measure how the child is functioning,
preferably from both a parent and a teacher, in order to
determine if any stress is playing a role in the child’s hair
Babies: 1 month to 2 years
Hair pulling at this age is
usually a self-comforting habit. It often goes along with
thumb sucking. The baby reclines with thumb or fingers in the
mouth and twists his/her own or his mother's hair with the
other hand. The child finds this relaxing and usually engages
in the behavior before falling asleep or when he/she is
Toddlers: 2 to 5 years
When a child has been pulling
at their hair since infancy, the toddler will be in the habit
of doing it without thinking. At around the age of three,
children can tell when parents are reacting to what they do.
If parents get worried or upset when their child pulls at his
hair, he soon will learn how to get parental attention with this behavior.
Hair pulling is used by the toddler as an effective addition to
kicking and screaming during a tantrum. Younger children
usually twist hair and the older ones pluck at their hair.
School age: 5 to 12 years
Trichotillomania can be a simple habit, an angry protest or a
sign that a child is
anxious or under stress. When a child only starts pulling
their hair out at school age, there may have been other
causes for the problem. It may be school-related stress or it
can be an indication that something is worrying ythe
During this period, many
children find it hard putting into words their troubles or
feelings. This is more often the case in children who pull
eyelashes or eyebrows. Children of this age become much more
secretive about pulling out their hair. It may be hard, as a
parent, to believe what is happening if they don't actually
see their child pulling out his or her hair. Efforts to catch
him/her doing it or frequent questioning will not help.
Adolescence: 12 to 18 years
Trichotillomania in adolescence
is frequently similar to another childhood behavior called
Obsessive Compulsive Disorder (OCD) which can cause the teen
to develop troubling thoughts and rigid rituals.
Alternatively, it may also be part of the adolescent struggle
to be independent, an expression of rebellion or a symptom of
Pulling hair out
does not cause permanent hair loss
available and effective
are different reasons for the same
behavior at different ages
When Trichotillomania is a
self-comforting habit, the management plan worked out by your
child's doctor will give parents ideas on how to help their
child. High risk times include when a child is tired, just before
falling asleep, watching television and when bored (eg. during
Ideas that may help include:
- A short haircut.
- Hair net or cap to sleep in.
- Cotton gloves or mittens for
high risk times.
- Give your child objects that
feel like hair to fiddle with, eg. pipe cleaners, satin
ribbons or feathers. These can be swapped about to keep your
Thumb sucking often goes with
hair pulling. These two habits must be worked on together
because they trigger off each other. Attempts to deal with one
habit at a time don't work well.
Distinguishing between the hair
pulling that is a comforting habit and hair pulling that is a
tantrum is important. Ignoring the behavior will lead to less
hair pulling only if it is being used in a tantrum. Attempts
to stop it may inadvertently alert the child to the
effectiveness of this behavior in upsetting the parent. If the
hair pulling is a habit, ignoring it will allow the behavior
to become more entrenched. Remove the child's hand from his
hair and give your child interesting objects to play with or
engage him/her in different activities.
Where the school age child is
pulling their hair out as a reaction to circumstances,
management involves searching for likely causes of stress,
developing support systems and encouraging communication. It
is helpful but not essential for the child to acknowledge what
they are doing and participate in efforts to stop eg
suggesting their own solutions, like a band aid in the thumb
to make it harder to grip the hair. If the hair pulling is
part of a repetitive ritualistic behavior, then the management
plan would be to use approaches similar to those for OCD. This
includes behavioral methods and medication, usually an
detailed descriptions of treatment options, check out the
American Academy of Pediatrics
"Helping the Young Hair Puller"
posted on kidsgrowth 02-26-07