It is common for children and
adolescents to play with their hair. However, frequent or obsessive
hair pulling can lead to serious problems. The medical term for
severe hair pulling is trichotillomania.
People with trichotillomania are not able stop pulling their hair.
As many as 1 person in 100 has the following signs and symptoms of
trichotillomania:
- recurrent hair pulling resulting in noticeable hair loss, unrelated to baldness or alopecia
- pleasure, excitement, or relief when pulling out hair
- embarrassment or shame resulting from hair loss
- problems at home or school.
The cause of trichotillomania is not known. For some children,
trichotillomania becomes damaging and very difficult to control. Hair
pulling can occur anytime but may become worse in stressful
situations. Most children with trichotillomania feel shame,
embarrassment or guilt about their hair loss. Younger children may
not notice or be bothered by hair loss. Older children and
adolescents may be teased, have low self esteem, anxiety or
depression.
Parents can become frustrated, as it is very difficult to
understand that children with trichotillomania can’t simply stop
pulling their hair. Neither parents nor children are to blame for the
hair pulling behaviour. Punishing children for pulling hair is
unlikely to decrease the behavior and can lead to problems with
self-esteem. In order to avoid punishment or embarrassment, children
try to hide or deny they are pulling their hair.
Frequently used treatments for trichotillomania include:
- cognitive behavioural therapy (CBT) is a specialized form of behaviour therapy. It involves helping a child recognize thoughts, feelings and behaviours associated with hair pulling. The goal of this therapy is to increase the awareness of hair pulling and replace it with alternative behaviours,
- medication therapy is also used to decrease the anxiety,
depression and obsessive compulsive symptoms that accompany
trichotillomania.
Family therapies and support groups are widely available. Children
with trichotillomania should be evaluated by a trained and qualified
mental health professional. Treatment is most effective when it is
individualised to the needs of the child and family.
