What is it?
What to look for
Psychotherapeutic: Trichotillomania is treated primarily through behavioral therapy. Cognitive behavioral therapy (CBT), which helps children become more aware of their hair pulling, is very helpful. Through CBT children can come to recognize the emotions and triggers involved in their hair pulling. Sometimes something as simple as wearing loud, dangling bracelets can make kids more self-aware.
After learning to recognize the habit, children can then begin habit reversal therapy. Some doctors recommend tricks that make hair pulling more difficult. For example, wearing bandages around the fingers and nails can make it harder to pull out hair, as does wearing hair pulled back or under a hat. For kids who enjoy the sensation of playing with the hair after it has been pulled, rolling a paper clip or playing with a textured pencil topper can help recreate the desired sensation and keep the hands distracted. Some kids in treatment carry kits around with bandages, paper clips, hair ties and other items that will help them. For children who compulsively pull out their hair, exposure and response prevention therapy, which diminishes the compulsion to pull hair by gradually increasing exposure to the triggers, can also be helpful.
Trichotillomania is sometimes difficult to treat because some children consider the sensations derived from pulling hair enjoyable, and they may need to be convinced that pulling out hair is a problem. If reluctant, children may undergo motivational interviewing, a technique used to help them commit to treatment.
Pharmacological: Medication is usually not the first choice in treating trichotillomania, although your child may be prescribed antidepressants like SSRI’s while she participates in behavioral therapy.
Frequently asked questions
No. Although children may experience a building tension that is released through pulling out their hair, this tension is not related to life stress. Pressures at home and school do not produce trichotillomania.
Does medication help?
Behavioral therapy is the preferred method of treating trichotillomania. Medication usually isn’t used in treatment, although in some cases children are prescribed antidepressants to boost the effectiveness of their therapy.
Will my child outgrow it?
Hair pulling usually is not a phase. Those who begin pulling out their hair during adolescence generally need intervention in order to stop. If your child’s hair pulling is becoming a problem you should seek treatment. The earlier treatment begins the better the prognosis will be.
Is it dangerous?
Trichotillomania can be dangerous if your child eats her hair after pulling it out (called trichophagia). Trichophagia can produce hairballs that block the gastrointestinal tract and may even result in death. Chronic hair-pulling can also result in permanent hair loss and infection.