Dear parent, it’s increasingly common for parents to turn to their pediatrician, seeking answers about “patches” of hair loss on their children’s heads.
There are numerous causes that can lead to spontaneous hair loss, but today we’ll focus on discussing a disorder that does lead to alopecia, but is caused by the voluntary removal of hair.
If you notice that your child is pulling out their hair, know that they might be suffering from trichotillomania.
Let’s look at this in detail.
What is trichotillomania?
Trichotillomania is a disorder characterized by an intense and uncontrollable urge to pull out one’s hair and body hair.
In young children, this behavior might start occasionally, then become a habitual behavior.
Although trichotillomania was long considered a very rare disorder, recent studies have shown an estimated prevalence between 0.6% and 3% (Grant et al., 2020; Thomson et al., 2022), suggesting that it’s not as rare as one might think.
Symptoms of trichotillomania
The main symptoms of trichotillomania are characterized by the repetitive and compulsive habit of pulling out one’s hair or body hair.
This behavior tends to focus, especially in the initial stages, on the scalp and face. The most commonly affected areas include:
- The scalp
- The eyebrows
- The eyelashes
But in reality, trichotillomania can affect any area of the body where hair grows: although less common, the disorder can involve other parts such as the pubic area, arms, neck, and legs.
Your child might repeat this gesture consciously and intentionally, but more frequently, it happens automatically and without the child realizing it.
Why do children pull out their hair?
The causes of trichotillomania are not yet fully understood and seem to be the result of various components. Although the origins of the disorder are not entirely clear, some risk factors have been identified:
- Heredity: studies have suggested that family predisposition may be a risk factor (Ramot, 2013).
- Prolonged anxiety and stress: children who experience stressful situations for a long period or suffer from anxiety are more likely to develop it.
- Acute stressful events: any particularly stressful event can contribute to the onset of the disorder.
Regardless of the causes that contribute to the development of this disorder, what leads children to engage in this specific type of behavior is the need to regulate an intense emotional state.
In fact, it is precisely through repetitive behavior, which can also become a ritual, that the child manages to alleviate the stress and emotional fatigue specific to a given situation.
How to recognize trichotillomania?
Recognizing trichotillomania in young children can be difficult, especially because early signs are often underestimated.
Each child is unique, and in their uniqueness, they experience different rituals: some wrap their hair around a finger before pulling it, some carefully run it between two fingers to enjoy the sensation of softness, some just put it in their mouth to suck on it, or some, after pulling it out, swallow it.
However, there are some indicative signs to consider:
- Bald spots: small hairless areas on your child’s scalp or other parts of the body.
- Broken hair: your child’s hair seems to be broken or of irregular length in some areas.
- Hair pulling: your child insistently pulls their hair, even while playing or falling asleep.
What to do if you suspect your child suffers from trichotillomania?
If you suspect that your child has trichotillomania, it’s important to act calmly and with understanding.
Although it may seem like a complex topic to address, always remember that it’s possible to treat this disorder, and the first step is always to turn to and trust a serious mental health professional, specialized in child development.
What you can do at home in the meantime is to monitor your child’s behaviors, especially in the presence of contexts that could put their serenity at risk, and offer the child a safe space without judgment, where they can talk, express themselves, and regulate without resorting to the compulsive gesture (even though it will still take a lot of time and patience).
Then, try to observe and notice when and where your child tends to pull their hair and/or note if there are recurring situations that lead the child to pull out their hair.
Create a calm and low-stress environment; routines can be very helpful.
And last but not least, remember never to resort to scolding and reprimands: not only is it useless, but it’s often counterproductive.
Conclusion
Trichotillomania is very frightening because, unlike other disorders, it’s tangible and visible on the body!
Remember, however, that you are not alone: there are resources and professionals ready to help you and your child on this journey.
We at Parentalife are here to support you with our guides, our courses, and with personalized consultations.
Remember, we are with you.
SOURCES
1. Grant JE, Chesivoir E, Valle S, Ehsan D, Chamberlain SR. Double-Blind Placebo-Controlled Study of Memantine in Trichotillomania and Skin-Picking Disorder. Am J Psychiatry. 2023 Mag 1;180(5):348-356. doi: 10.1176/appi.ajp.20220737. Epub 2023 Feb 22. PMID: 36856701.
2. Ramot Y, Maly A, Horev L, Zlotogorski A. Familial trichotillomania in three generations. Int J Trichology. 2013 Apr;5(2):86-7. doi: 10.4103/0974-7753.122968. PMID: 24403772; PMCID: PMC3877480.