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Home
and Family
Trichotillomania
by A. Ross, M.Ed.
It would be interesting to know how many readers are going to
skim over this article, or how many will reach for the
dictionary. The title is a fancy word for a very common
childhood habit. In fact, it is not only common in children;
there are many adults who indulge in the habit, too. It just
means `hair pulling.' Any hair, be it eyebrows, eye lashes,
beard or mustache. Some do it discreetly and some pull so
frequently that they have bald patches on the head or in the
beard.
Babies as young as one month are seen sucking their thumbs
while twisting bits of hair. Sometimes they only suck,
sometimes they only twist their hair, or maybe, the mother's
hair. But the two often go together. The habit is no worse
than any other habit, like nail biting, and if it begins in
infancy, it is not a sign of stress or unhappiness. It is
just a comforter, like a favorite blanket or teddy. If the
child has been pulling out hair since he was a baby, the
chances are that he will still be doing it when he is four or
five. If he sees that you are worried or upset by the habit,
he will use it to gain your attention. He will use hair
pulling in the same way as a child uses a temper tantrum as a
way to manipulate his parents.
If a school age child who has never done it before starts
pulling out hair, it is often not just a simple habit. It may
be a warning that something is worrying the child or it may
be his way of protesting against something, either in the
home or at school.
Trichtillomania in its worst form is recorded as one of the
obsessive compulsive behaviors (O.C.B.). The worst form
consists of the child compulsively pulling out a handful of
hair and then eating it. Doctors come across underweight
children with large `nests' of hair blocking the stomach.
Recently, there was a girl of fourteen who had completely
lost her appetite, and yet was not anorexic. After extensive
tests, the doctors decided to operate. They found a lump of
hair which weighed about nine pounds! The girl must have been
pulling out hair for years, without her parents noticing
it.
Treatment varies according to the age of the child, and also
depends on whether the child wants to stop or not. In my own
family, a little girl was pulling out hair fiercely from the
age of about a month and soon after, she was eating it. When
she was about two years old with large bald patches and
untidy tufts of hair, we braved all the neighbors'
disapproval and shaved her head close. Thus she was unable to
pull any hair, let alone eat it. Friends, relatives (apart
from a few) and neighbors did not realize she had a problem,
and felt that they should voice their opinions to young
inexperienced parents. We kept it shaved close for about a
year, meanwhile giving her a furry animal to hold and to
comfort her. By the time the hair had a chance to grow again,
she had forgotten about the habit.
This treatment works well up to the age of around five. After
that, a child cannot be exposed to well-meant comments,
although it is less problematic for boys in some communities
where their peers all have close shaven scalps and just
payos. They twist them, curl them and twirl them, but
they do not pull them out.
An older child who expresses a wish to overcome the habit
could be given a small bunch of feathers or pipe cleaners or
anything that feels a little like hair. They are usually more
motivated if they have done extensive damage to the hair and
it is noticeable. Incidentally, apart from the danger of hair
being indigestible and blocking the stomach and intestine,
there is no permanent damage done. The hair will grow back
again. If you did not manage to help your older child, it is
worth asking for professional advice. Some children bite
their nails into adulthood, others chew their pencils and
really make a meal out of them. Hair pulling is not really
any different, so don't panic about it if you notice that
your child is doing this.
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