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When Children Pull Their Own Hair

by Sue Hubbard, M.D.

I received an email via our iPhone App from a mother who was concerned that her 12 year old son had started pulling out his eyelashes.  This is called trichotillomania.

Trichotillomania is an impulse control disorder which is characterized by “the excessive pulling of one’s own hair which results in hair loss.” It may be eyelashes, like this adolescent boy, or it may be hair on any other part of the body.

It most commonly involves scalp hair, but eyelash and eyebrow pulling is the second most common site.  The hair pulling may result in small amounts of hair loss, which may not even be noticeable, to such excessive pulling resulting in total loss of eyelashes, brows or even baldness.

Hair pulling in childhood may begin during toddler and pre-school years, where it seems to be more of a “habit” than a compulsion. In this case the hair pulling is typically short lived and resolves on its own.

Hair pulling that occurs in children of older ages (peaks are seen between the ages of 5 -8 and during the teen years) is a type of obsessive compulsive disorder where the person cannot resist the behavior and of may even experience gratification when pulling out their own hair. At this point the compulsion leads to the inability to resist pulling one’s own hair, which may in turn cause more anxiety and stress, which then leads to more hair pulling and a vicious cycle occurs. At this point ,the behavior may have gone on for months and then is labeled trichotillomania.

In my own experience with children who have trichotillomania, the child often tries to hide the behavior, and may even deny the hair pulling despite the fact that they have an area of baldness or even no eyebrows. They will often act is if they cannot figure out how the hair loss occurred. Parents too may not see the child  actually pulling their own hair and also are confused as to the etiology of the hair loss.  Children may experience a great deal of distress secondary to their hair pulling,  not only from the actual loss of hair, but they may also avoid school or social situations due to embarrassment.

Self inflicted hair pulling is a psychiatric disorder that is often difficult to treat and requires professional help. When seeking professional help look for a psychologist or psychiatrist who has experience in this area.

That’s your daily dose for today.  We’ll chat again tomorrow!

Send your question to Dr. Sue!

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