Help: My child pulls her hair out!

If your child can’t stop pulling out their hair, they may have a condition known as Trichotillomania.

Trichotillomania is a condition marked by the impulse to pull hair out at the root and can affect people of all ages. When the condition presents in children, it can be difficult to solve since the child is unable to self-examine and understand the root causes of the condition.

The reasons behind why children pull out their hair are not known for sure, with some studies pointing to the genes and others claiming that adding a simple supplement to the diet may help curb the behaviour.

As a form of OCD, the causes of trichotillomania are likely to vary from one person to the next and kidshealth.org explains that: “Some people say that the urge to pull starts with a feeling in their scalp or skin, like an itch or a tingle. Pulling the hair seems like the only way to get relief. People might have a brief feeling of satisfaction for a moment after pulling out their hair.”

It happened to us

Here, one mom shares her journey helping her daughter through trichotillomania…

Although Leane was working full-time, she felt reassured that her daughter Ava was being well cared for by her mom while she was at work – surrounded by a loving family. But when her mom’s health took a turn and she could no longer look after Ava on a daily basis, they decided to enrol her in a preschool. After all, she was 18 months old.

“Ava started twirling her hair as a self-soothing tactic when she was about 6 months old, but I think when she started school and was in a new environment away from family for the first time, anxiety set in and she began to pull at her hair,” says Leane.

Their first port of call was their paediatrician, who wanted to rule out any biological causes such as an itchy scalp. Ava was prescribed ointments, but they didn’t help the behaviour.

“We then tried play therapy, but that simply confirmed what we already knew – that pulling at her hair was a self-soothing mechanism and we needed to introduce other, more appropriate, soothing mechanisms.”

This proved easier said than done, so for the next four years Ava’s hair was kept short in order to prevent any long-term damage to the hair growth and the family worked together with an occupational therapist and paediatric specialist to help Ava redirect her behaviour.

Finding solutions

The neurological paediatric specialist confirmed what the family believed to be true: “Our daughter is very bright, likes to be in control, and is impulsive. She is also sensory sensitive, so when she feels overwhelmed, feels she is not in control or that she is not being allowed to act on her impulses, anxiety kicks in and she reverts to her coping mechanism of pulling at her hair,” explains Leane.

Since Ava experiences sensory overload, which triggers anxiety, they introduced sensory tents and headphones. The sensory tents provide a quiet, contained environment that isn’t over-stimulating and the headphones can help her to block out noises or environments she finds overwhelming. She regularly engages in soothing activities such as painting and drawing and is allowed to be completely in control of what she is creating.

The family talk with Ava regularly about how she is feeling by asking her what made her feel sad, happy, or angry. They help her unpack her feeling so they don’t remain bottled up inside and manifest as anxiety. Ava has now found other ways to soothe herself and never goes anywhere without her beloved stuffed bunny.

“She now relies on this more than the feeling she may get from pulling her hair,” says Leane. “We tried introducing yoga as a calming exercise but Ava just didn’t take to it. She has taken up karate at school and that has helped with discipline and controlling her impulsiveness. It has also improved her confidence and deregulated her hypersensitivity.”

Did you know?

• Trichotillomania severity can range from mild to very severe.
• Trichotillomania is more common in teenagers and young adults.
• Trichotillomania may cause feelings of shame and low self-esteem in some children.
• Older children affected may try to keep their condition to themselves.
• The habit of eating hair can be dangerous and cause hairballs to form in the stomach, leading to serious illness.

When to see a GP

Take your child to see your family doctor as soon as you discover they are pulling their hair out.  Your GP may examine areas where your child’s hair is missing to check that nothing else is causing their hair to come out, such as a skin infection. If your GP thinks your child has trich, your child may be referred to a specialist.