I’ve noticed that my five-year-old daughter’s hair has become thinned out with small round bald patches in places.Lately she always seems to be tugging at it. Could this be something serious?
It may be a condition called trichotillomania. It is a type of compulsive behaviour involving the repeated pulling or twisting of the hair until it breaks off. Although the cause is not entirely understood, it has been estimated to affect up to 4 per cent of the population. Women are up to four times more likely to be affected by the condition than men. Symptoms commonly begin before the age of 17. The hair may come out in round patches or across the scalp resulting in an uneven appearance. Trichotillomania sufferers may also pluck other hairy areas, such as the eyebrows, eyelashes, or body hair.
The condition in children can give rise to a wide range of symptoms including an uneven appearance to the hair; diffuse loss of hair; and constant tugging, pulling, or twisting of hair. When the hair grows back it often feels like stubble.
I’ve tackled her about it and she denies she is doing it. However, I’ve witnessed her doing it and have noticed that it usually occurs when she’s upset. Strangely, pulling out her hair seems to calm her down.
Denial of hair pulling is not uncommon. Others signs that trichotillomania is the correct diagnosis include an increased sense of tension before the hair pulling with subsequent sense of relief, pleasure, or gratification after the hair pulling. Other self-injury behaviours may also be evident. In some sufferers there may be a tendency to eat the hair pulled out, which can lead to an obstruction in the bowel.
What can be done about it?
Examination by your family doctor to out rule other possible causes such as fungal scalp infections or alopecia is important. Once a definitive diagnosis of trichotillomania is made, a management plan can be implemented. Stress may increase compulsive behaviours; the first step in managing the problem is to try to eliminate any source of stress in her life. The good news is that younger children with trichotillomania tend to outgrow the behaviour, with hair pulling ceasing within 12 months.
Children who start pulling hair before the age of six tend to do better than those who start later. Behavioural therapy and other psychological therapies may also be effective.
Trichotillomania
Trichotillomania is the habitual pulling out of normal hair. Although the habit is most common in children but can also occur in adults. The condition may be mistaken for another illness such as alopecia or fungal infections that can cause hair loss.
