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  • Writer's pictureSmridhi Malhotra

Hair Pulling and Twirling in Kids: Understanding Trichotillomania in Children


Trichotillomania is a disorder associated with the urge to pull out hair from the scalp or any other body parts. It's more associated with kids. It's a condition that many parents find hard to stop a child from pulling hair out.

They mainly do it unconsciously, which makes parenting a child with trichotillomania a very dense task. Some eat the hair after pulling it out of their scalp. Below is a guide to understanding trichotillomania in children, the signs and the treatment.

Signs of trichotillomania

There are evident red flags that will indicate that your child is suffering from trichotillomania. They include asymmetrical hair loss, hair on the floor, or pillows. To some extent, you may notice that the kid has hands constantly near the head. Whenever you see such signs, do not ignore or assume it's ordinary that toddlers pull hair out and eat it; to be sure, it's a sign of a big problem that is affecting their health.

Wearing hats or other cover-ups or constantly checking mirror reflections may also be signs of trichotillomania disorder. Most kids already know what is happening to them, but they are not in control of it. Some describe a feeling of tension after pulling out the hair, especially those that pull it consciously.

Many questions crisscross the minds of different parents, like a child pulling hair out will it grow back, or is a child pulling hair out when mad? The answer is that your child might not be mad, the hair will grow back, but they will tend to pull it out again. Eventually, they may suffer from low self-esteem due to the conditions of their hair.

Trichotillomania risk factors

Trichotillomania is more rampant in girls than boys. It's more common to kids who have OCD or associated with first-degree relatives who have it. Trichotillomania causes cyclical anxiety that makes the child pull out hair more concurrently. If a toddler pulls hair out and eats it, that may be a risk to digestion, especially if they do it more often.

Trichotillomania diagnosis

Trichotillomania is diagnosed in kids who have established a recurrent habit of pulling out hair, and to a larger extent, it's causing them significant discomfort. For the criteria to be valid, your child must have made repeated attempts to decrease the behavior, but their efforts have been futile. Ensure that your kid is tested for scalp infections, spot blindness, or alopecia, as it's hard to diagnose, especially in kids.

It's good to understand two types of this condition; automatic hair pulling and focused hair pulling. For robotic hair pulling, your kid may not realize they are doing it until after the fact while in focused hair pulling, the child will do it intentionally because they feel good about it.

Trichotillomania treatment

Trichotillomania treatment is usually through behavioral therapy, mainly through cognitive behavioral therapy, making your child more aware of the hair-pulling habit. The child is taught to recognize the emotions and different triggers that are involved in their pulling. 

To treat trichotillomania, sometimes doctors will recommend tricks that will make the habit more difficult. For example, they may recommend your kid to wear bandages around the fingers or nails that make it hard to enjoy the process.

Carrying treatment kits around with paper clips, hair ties, or other items that will help them play with them instead of the hair will shift their focus to something else beneficial.

Sometimes your child may be put under medical prescription while participating in behavioral therapy. But in most cases, it's usually not the first choice of treating trichotillomania if the treatment can work out things in a better way.

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