What Triggers Hair Pulling in Children (Trichotillomania), and What Can You Do?

When things get stressful, some kids turn to pulling their hair as a coping technique. If this behaviour turns into a compulsive habit, it can be trichotillomania.

Although many kids play with their hair, persistent and compulsive pulling may indicate trichotillomania in young children. This psychological disorder is characterised by persistent, compulsive urges to remove hair from the scalp, eyebrows, eyelashes, or other parts of the body, which results in visible hair loss.

However, children can manage and even overcome trichotillomania with time and supportive techniques.

When under stress, why does your child tear out their hair?

Some kids use hair pulling as a coping technique when things get tough. This conduct could provide a brief moment of solace or diversion from overpowering feelings or circumstances.

It is possible for the physical act of hair-pulling to deflect attention from emotional suffering. In circumstances where your child might otherwise feel helpless or nervous, it might also provide them with a sense of control.

Does trichotillomania in children have a connection to a mental illness?

While co-occurring disorders, or comorbidities, such as attention deficit hyperactivity disorder (ADHD), depression, or obsessive-compulsive disorder (OCD), are frequently present in individuals with trichotillomania, they are not necessary for a diagnosis.

Although trichotillomania can occur in some individuals without any comorbid mental health issues, it has been linked to several other illnesses.

OCD

Since trichotillomania entails repetitive behaviours, it is frequently seen as a member of the OCD-related disorder continuum.

Genetic connections between trichotillomania and other OCD-related disorders, such as excoriation (skin plucking) disorder, have been suggested by certain twin studies.

Tic disorders

Tourette syndrome and other tic disorders may be associated with trichotillomania.

Though trichotillomania is now classified as OCD in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition text revision, the authors of a 2020 study review speculate that it may be more closely linked to tic disorders.

This correlation could impact trichotillomania treatment choices.

Anxiety disorders

Anxiety disorders like panic disorder, social anxiety disorder, and generalised anxiety disorder frequently co-occur with trichotillomania. Additionally, it's frequently associated with worry or distressing feelings that come before the hair-pulling behaviour.

About 28% of 530 persons with trichotillomania who participated in a 2017 study also had an anxiety problem.

In children, the percentage can be comparable. Anxiety related to pulling behaviours was indicated by 24–30% of children with trichotillomania in previous investigations, as cited by the authors of a 2017 study.

Depressive disorders

The symptoms of depression are rather typical in trichotillomania. Adults with trichotillomania are thought to benefit most from selective serotonin reuptake inhibitors (SSRIs), which may also be beneficial for younger patients.

The worst symptoms occur in adults who have trichotillomania along with anxiety and sadness. Though further study is required, this might also apply to kids.

ADHD

There is some evidence to support a possible correlation between trichotillomania and ADHD, however, it is not as strong as it is for the other diseases listed above.

Researchers discovered that 15.3% of 308 adults with trichotillomania in a 2022 study also had ADHD.

It's crucial to understand that trichotillomania isn't the only diagnosis for excessive hair pulling. To be classified as trichotillomania, hair pulling needs to significantly disrupt everyday functioning or create great distress.

How to support your child with trichotillomania

Providing a child with a supportive environment and tools to assist them in properly managing stress are important aspects of supporting a stressed-out child. There are many ways you may help your child embrace change, but the strategy you use will probably alter based on how old they are.

Emotional support

• Stay calm: Be calm and impartial when handling the situation. Refrain from losing your temper or becoming irate since this could make your youngster feel embarrassed or ashamed.
• Talk with your child: Talk to your child honestly and openly about their hair pulling. Invite them to talk about their emotions and any triggers that they may be experiencing for this behaviour.
• Engage in active listening: Observe your child without passing judgment. Acknowledge their emotions and assure them of your support.

Immediate changes

• Identify triggers: Assist your child in identifying the stress, anxiety, or boredom triggers that cause them to pull their hair. After determining the potential triggers, focus on locating substitute coping strategies or diversionary activities.
• Use barriers or distractions: To prevent hair tugging, try utilising caps, gloves, or fidget toys as physical barriers or diversions.
• Limit stressors: Determine your stressors and try to reduce them. For example, if your child is always stressed out by certain events or activities, look for ways to decompress or find other activities.
• Encourage positive reinforcement: When your youngster resists the impulse to pull their hair, give them praise. A strong incentive for behaviour modification can be found in positive reinforcement.

Long-term interventions

• Teach stress-management techniques: Your child can learn to relax by engaging in practices like deep breathing, mindfulness, and visualisation when they are under pressure.
• Establish routine and predictability: Keep your daily schedule regular at home. Particularly in trying circumstances, security can be derived from predictability and organisation.
• Encourage hobbies and creativity: Get your kids involved in interests or pastimes they enjoy. Stress can be reduced by engaging in any creative activity, such as writing, singing, or drawing.
• Monitor progress: Observe your child's advancements and failures. Remain patient and enjoy little triumphs because trichotillomania can be gradually overcome.

Managing your child’s trichotillomania

Taking into consideration your child's requirements as well as any co-occurring illnesses, early intervention and a customised treatment plan can significantly improve the management of trichotillomania.

Children with trichotillomania are usually treated with a mix of methods:

• Behavioural therapy: For trichotillomania, habit reversal training and cognitive behavioural treatment are frequently utilised. With the use of these therapies, your child will be able to recognise the situations that set off their hair-pulling urge and learn substitute behaviours.
• Supportive counselling: Counselling, either individual or family, can assist your youngster in comprehending and regulating feelings associated with hair pulling.
• Medication: Doctors may occasionally recommend drugs like SSRIs to treat comorbid symptoms, especially if your child has an underlying anxiety or mood condition.

FAQs

Can you fully recover from trichotillomania?

The discovery that about 25% of adults with a history of trichotillomania get well implies that trichotillomania does not always progress chronically or persistently and that different people experience the disorder in very diverse ways.

Does trichotillomania ever stop?

Trichotillomania is a chronic illness. Symptoms may come and go for weeks, months, or even years if they are left untreated. Moreover, the intensity of symptoms can change over time. For instance, some women's symptoms may intensify due to hormonal changes that occur during the menstrual cycle.

Bottom line

Trichotillomania in children necessitates tolerance and comprehension. A supportive atmosphere, individualised therapies, and early intervention help many kids learn how to cope with and get past this illness.

By handling the matter gently, getting expert aid, and providing a supportive atmosphere, you can assist your child in managing and overcoming hair pulling and hair loss.