Hair Pulling (Trichotillomania)
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 pull hair on various parts of their bodies, including the scalp,
face, arms, legs and pubic areas. They may not notice the hair pulling until they need to
cover up bald patches with hair clips, a hat, wig or scarf. 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, school or work
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 behavior. 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 behavioral therapy (CBT) is a specialized form of behavior therapy. It
involves helping a child recognize thoughts, feelings and behaviors associated
with hair pulling. The goal of this therapy is to increase the awareness of hair
pulling and replace it with alternative behaviors
• medication therapy is also used to decrease the anxiety, depression and obsessive
compulsive symptoms that accompany trichotillomania Family therapies and support groups are also available. Children with trichotillomania
should be evaluated by a trained and qualified mental health professional. Treatment is
most effective when it is comprehensive and individualized to the needs of the child and
family.
Quazi Imam, M.D.
Board Certified in Psychiatry.
Board Certified in Addiction Psychiatry.
Board Certified in Geriatric Psychiatry.
Board Certified in Forensic Psychiatry.
Former Assistant Professor of Psychiatry, Mount Sinai School of Medicine, NY.
Child & Adolescent Psychiatrist,Harvard Medical School Trained.
1833 W. Pioneer Parkway Tel: 682-323-4566
Arlington, Texas 76013
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 pull hair on various parts of their bodies, including the scalp,
face, arms, legs and pubic areas. They may not notice the hair pulling until they need to
cover up bald patches with hair clips, a hat, wig or scarf. 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, school or work
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 behavior. 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 behavioral therapy (CBT) is a specialized form of behavior therapy. It
involves helping a child recognize thoughts, feelings and behaviors associated
with hair pulling. The goal of this therapy is to increase the awareness of hair
pulling and replace it with alternative behaviors
• medication therapy is also used to decrease the anxiety, depression and obsessive
compulsive symptoms that accompany trichotillomania Family therapies and support groups are also available. Children with trichotillomania
should be evaluated by a trained and qualified mental health professional. Treatment is
most effective when it is comprehensive and individualized to the needs of the child and
family.
Quazi Imam, M.D.
Board Certified in Psychiatry.
Board Certified in Addiction Psychiatry.
Board Certified in Geriatric Psychiatry.
Board Certified in Forensic Psychiatry.
Former Assistant Professor of Psychiatry, Mount Sinai School of Medicine, NY.
Child & Adolescent Psychiatrist,Harvard Medical School Trained.
1833 W. Pioneer Parkway Tel: 682-323-4566
Arlington, Texas 76013
