Trichotillomania in children

by Tshepy Matloga-Malope
Reading Time: 3 minutes

Trichotillomania (TTM), also known as hair-pulling disorder, is a psychological condition characterised by the compulsive urge to pull out one's hair, leading to noticeable hair loss. By Tshepy Matloga-Malope.

According to Mental Health SA, TTM has a reported prevalence of 2.0% to 2.5% in the United States. Despite increasing research and clinical focus on TTM locally, the prevalence of TTM in South Africa is not known. Nevertheless, the true prevalence of TTM worldwide may in fact be higher than the US rates, indicating that many patients with TTM are very secretive about the disorder.

This condition commonly affects children, although it can persist into adolescence and adulthood if left untreated. Trichotillomania is often accompanied by feelings of tension before pulling out the hair and a sense of relief or gratification afterward.

Lerato Mathekga, a registered counsellor with expertise in treating childhood anxiety disorders, including trichotillomania, says, “Trichotillomania in children can be a challenging condition to address, but with early intervention and appropriate support, many children can learn to manage their symptoms effectively. It’s essential for parents to be patient, understanding, and seek help from mental health professionals.”

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Causes of trichotillomania

The causes of trichotillomania can vary and are not entirely clear-cut. Some factors that may contribute to its development include:

  • Genetic predisposition
  • Abnormalities in brain chemistry
  • Emotional stress
  • Trauma
  • Certain personality traits.

Children who experience high levels of anxiety, depression, or have difficulties coping with stress may be more at risk of developing trichotillomania. Trichotillomania usually develops just before or during the early teens, most often between the ages of 10 and 13.

Trichotillomania symptoms

People with trichotillomania often try to stop pulling their hair but can’t. They also say that pulling has negative effects on their lives, self-esteem, or well-being. Pulling can be focused or automatic. With automatic pulling, you aren’t aware that you’re doing it. Automatic pulling might happen when you’re studying, reading, or watching TV and not paying attention. Automatic pulling can be a response to feeling bored.

However, with focused pulling, people know that they are doing it but can’t stop themselves. Focused pulling can be a way to ease stress or soothe yourself. Most of the time, people with trichotillomania pull out their hair with their fingers, but might also use tweezers or other tools.

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Preventing trichotillomania

Preventing TTM involves creating a supportive and understanding environment. Parents and carers should be observant of any early signs of hair pulling and seek professional help if needed. “Teaching children healthy coping mechanisms for stress and anxiety, such as relaxation techniques or cognitive behavioural therapy, can also be beneficial in preventing the onset of trichotillomania,” says Mathekga. 

Treatment for trichotillomania

Treatment typically involves a combination of therapies tailored to the individual’s needs:

Cognitive-behavioural therapy (CBT) has been found to be particularly effective in helping children manage and eventually overcome their hair-pulling behaviours. CBT focuses on identifying triggers, challenging negative thoughts, and developing alternative coping strategies.

Habit-reversal training. This behavioural therapy is the main treatment for trichotillomania. The person learns how to recognise situations or triggers where they might likely to pull out their hair and how to substitute other behaviours instead.

In severe cases, medication may be prescribed to help alleviate symptoms of anxiety and depression that often coexist with trichotillomania. It is essential for parents and carers to work closely with mental health professionals to find the most suitable treatment approach for their child.

In conclusion, trichotillomania is a complex disorder that can significantly impact children’s well-being if left untreated. By understanding the causes, implementing preventive measures, exploring treatment options, and seeking professional guidance, parents and carers can help their children overcome trichotillomania and lead happier, healthier lives.

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