Trichotillomania (Hair Plucking)

Parent Q&A

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  • My 12.5 year old daughter has started plucking her hair out to the point that her part is noticibly wider and she’s getting a small bald spot at the crown of her head.  
     

    I noticed the hair loss and was worried it was thyroid issues or potentially alopecia so took her to her doctor.  Doctor said it hair plucking and I had started noticing her pulling at her hair after I noticed the wide part.  
     

    She is not at this point too open to any of the suggestions of the pediatrician ( wear a hat, wear hair back so don’t pick ) and doesn’t want to discuss it.  She doesn’t appear to be stressed out in any way but does have some anxiety issues and sensory issues.  
     

    She has a therapist but her therapist didn’t have much to offer as far as how to address it.  Are there therapists who specialize in addressing things like this? If so, I’d love a recommendation.  

    As you describe it, this is a compulsive behavior that can be treated (with CBT and/or anti-depressant or anti-anxiety medication) or you can attempt to environmentally manage it, as your doctor suggested. Managing it is obviously (IMHO) a band-aid approach. The condition is called trichotillomania and there are many online support groups, including some with Bay Area members, and the larger universe is called body-focused repetitive behaviors. It shares characteristics with Tourette syndrome and OCD. Many, many people display one or more of this kind of behavior and you and your daughter are not alone!

    My 14 year old started doing the same thing. It’s trichitillomania. I have just gotten her a therapist—first session on the 9th, but this is a therapist to help her deal with anxiety and feelings in general. If you’d like to talk I think it could be helpful for both of us. 
     

    my daughter alerted me to her pulling. She pulls from the front of her head, at the part. It started during covid due to social isolation. And sometimes she just does it now while relaxing out of habit. I used to pick my skin (adult acne) out of this idea that I could make it better or sometimes just to try to smooth it out or in times of stress and so I feel like I understand when brought trichitillomania about. She feels like she’s doing better but I still see small scabs and bare patches. It’s so sad to see this clear visual of her inner turmoil. I have nightmares about it. 
     

    feel free to call me if you want. You can get my contact info from moderators?

    My goddaughter had this problem. Trichotillomania is a known disorder related to OCD.  There are specific behavioral therapies, including CBT, and in refractory cases they use medications.  Your therapist sounds like she's not up to the job.  There are some here in the East Bay that specialize in OCD.  Maybe they can guide you.  Good luck!

    I wanted to let you know you're not alone.  My daughter is the same age now as yours and she had a bout of trichotillomania in 2nd grade when she had a stressful year. She had shown a tiny bit of it prior to the stressful time.  In part, she had a belief that she didn't like the new hair growing in at the hairline and she kept plucking it out, as her hairline receded noticeably.  That stopped once I explained that she needed to let it grow back to have normal bangs again.  But, following something that happened that was very upsetting to her, in the space of a couple hours, she made a sizeable bald spot at the crown.  The teacher reported to us that other students were asking about it, having seen her pulling.  We did a comb-over for a couple months, also tried using scarves.  Then she tried pulling where it couldn't be seen at the nape of her neck for a short time, and stopped.  And she has also pulled out a couple eyelashes sporadically.  

    The pulling largely subsided after that episode.  She did some thinking on her own and decided not to do it.  I believe she has developed her own internal coping strategies to deal with the urges that cause it.  I have read online that some people even pull in their sleep, so conscious strategies may be less helpful, but perhaps there are other strategies that may help relax or reduce the urge.  As I'm writing, this sounds like it's a big deal, and it WAS, but since that year, it's barely an issue at all.  Hopefully (knock wood) it will stay in the background.  I hope the same for your daughter.

    As parents, it was extremely upsetting to look on the web and consider it might be a long term issue with big social consequences.  We wanted to be supportive and tried not to make too big a deal, I didn't want her going underground.  I could always tell when I would find healthy hairs on the floor or bedsheets with the root attached.  I didn't know about it then, but tapping (look it up) might be a good practice to build resilience to stress and boredom.

    Look up trichotillomania and you will find lots of info.

    There is an organization in Santa Cruz with helpful resources: https://www.bfrb.org

    This article was helpful:

    http://alimattu.com/blog/2010/10/7/a-beginners-guide-to-treating-tricho…

    The TLC Foundation has great resources on their website. https://www.bfrb.org/learn-about-bfrbs/trichotillomania.  I suggest you look for a therapist has specializes in skin picking / hair pulling. It often falls under anxiety related disorders and/or OCD. My daughter used a great workbook for skin picking which was very helpful to her and I assume there are similar for hair pulling. Check with TLC about resources, support programs, parent education, etc. 

    Good luck

  • A friend's daughter is suffering from trichotillomania, and they haven't been able to find any other pre-teen/teen kids for her to connect with. They live in the Sacramento area, but with social media these days, there must be some kind of support online. Does anyone have any advice? Many thanks!

    Hi,

    You'll want to check with bfrb.org It stands for Body Focused Repetitive Behaviors. They have wonderful resources.

    Good luck.

    Hi Again,

    Yes, bfrb.org is a great group. You asked for advice... learn about this behaviors and issues - it's not an issue of will-power, but of habit and other issues. Look into treatments and ensure the family is on board - no shaming needed - everyone can work together on this. Their are books to read on this, workbooks to use. Cognitive Behavioral Therapy has been known to work well for many people.

    Good luck.

    Suggest the TLC foundation at https://www.bfrb.org/and the international OCD Foundation for resources and support groups. https://iocdf.org/

    The Facebook group “tricky picky parenting” is very active. It includes experiences with body based repetitive disorders such as trichotillomania and skin picking. There’s also a conference every year for families on this topic, sometimes it’s held in the bay area. People in the Facebook group can share more.

  • 4yo pulling hair out

    Sep 23, 2017

    My daughter has always pulled her hair out.   She runs it across her lips and at times consumes it.   Everyone said she would outgrow it but I'm beginning to believe we need to seek help for her. Does anyone know of local play/cognitive behavioral therapists for little ones, specifically dealing with this condition?

    Please check out bfrb.org. It's a wonderful, supportive resource for people & families dealing with body focused repetitive disorders (BFRBs). Trichotillomania (hair pulling) and trichophagia (hair eating) are types of BFRBs, as are skin picking, nail biting, and other disorders. Among the wealth of information on this site, there are recommendations for therapists.

    Your child's pediatrician should especially be made aware (if not already) of the trichophagia, as that can have serious health implications.

    Best wishes to you & your daughter.

    My daughter did the same thing at the same age. We finally cut her hair really short and with not much to pull, she stopped. Problem solved and her hair is way too long now. Good luck with whatever you try.

    This is called trichotillomania. I pull too.

    I don't know about resources for such a young person, but you can start here:

    http://www.bfrb.org/

    especially http://www.bfrb.org/learn-about-bfrbs/tools-a-info-for/for-parents

    check out the SF Bay area Center for cognitive therapy in Oakland-- this condition is called trichotillomania and is on their list of treated disorders. 

    And they do see kids. 

    http://sfbacct.com/treatment-at-the-sfbacct/problems-we-treat/

    good luck!

    Check out http://www.bfrb.org/find-help-support.  Lots of books as well as online resources available here.

    There is also a wonderful therapist in Santa Rosa named Litsa Tanner and I'm sure you could do a phone consultation with her: http://srcbt.org/litsa-tanner-mft/

Archived Q&A and Reviews


Questions

Therapist/Psychiatrist for 11 yo's Hair-Pulling

Oct 2010

My 11-yr-old has recently started pulling out his hair. The first time, a few weeks ago, he created a bald spot about the size of a quarter. After we showed it to him in a mirror he seemed pretty committed to not doing it again. Then yesterday he did it again, enlarging the spot to a bit more than silver-dollar size. He says he's ''addicted'' to pulling. Apparently this is a not-uncommon disorder, called trichotillomania. I'd really appreciate recommendations for treatment. We live in the Lamorinda area but are willing to travel a bit to see someone good. A Kaiser person would be ideal, though that's not necessary. Also, if anyone who's been through this has any advice to offer or experiences to share, I'd be very grateful. Thanks, Worried mom


Trich is very common, as you already know. It is very hard to 'cure,' however, as the problem lies in the brain --technically, it's called an impulse disorder. Your son's brain registers as pleasurable something that hurts--it hurts him, just like it would hurt anyone who pulls-- but for him, the discomfort stops when he pulls. It may seem backward and upside down to us, but it makes sense to a kid with trich -- it's a kind of comfort mechanism. But the results are seriously damaging, needless to say. Very few counselors specialize in trich, and when my daughter suffered from it, aged 14-21, she saw a specialist who I had mixed feelings about in San Rafael, who was at that time the only person in a reasonable driving range who specialized in trich. I think she offered some good moral support, and the fact that she had a group (all girls, alas for your son) was helpful, too. I can offer you some hope: my daughter, now 23, has stopped pulling. This is after years of therapy and her own personal efforts. On and off, she improved (two steps forward, one back) for years, only to fall back badly during times of increased stress. She wore wigs during two different periods, in which she had pulled more than half her hair out.

She now is through it, I suspect for life. But the statistics I've seen indicate that this kind of full recovery is not common. I think it's great that you found it early, and I urge you to find out everything you can and be very cautious about how you address the issue with your son until you get professional advice yourselves, you and your spouse. He is right; it is a kind of addiction, but there is not medicine or 'method' to stop pulling. The self control it takes is truly phenomenal. I offer you the comfort of knowing you are not alone, and hope you find ways of coping as parents, and ways to support your son, that are healing and beneficial for you all. best wishes, someone who's been there


I'd recommend a talented psychotherapist with a reputation for helping youth with obsessive behaviors: Reyna Cowan has an office in the Rockridge Harriet


I wanted to share a few resources with you. My daughter started pulling her eyelashes just over a year ago and I went through an extensive search for someone who specializes in hair pulling.

First of all, I wanted to be sure you know about trich.org, the website of the Trichotillomania Learning Center. Lots of good info on there. They have a provider listing under ''Treatment and Resources'' of therapists who specialize in treating trich. My daughter has been seeing Wendy Ritchey in Walnut Creek since the beginning of this year, and has had some success. Just now her lashes are coming in thick again, though short. It does continue to be a struggle for her--harder at times than others, it comes & goes. Wendy works with children and adults, and has a workbook she uses with kids that has exercises that help identify triggers, feelings and substitutes. We've enjoyed working with her.

Just found your original post...we're in Lamorinda too. And my daughter started pulling at 11y.o. too. I think the middle school transition is very stressful for some kids... Please contact the moderator if you'd like my email address so we can communicate further. Christina


Didn't see the original post, but have a book to recommend. Someone on this list recently told me about ''Habit Control in a Day''. It was really helpful for my habit of cheek biting, and there were many sections that were devoted specifically to hair pulling. Possibly as an adjunct to therapy for you? I ordered it through interlibrary loan at Berkeley library, and read it in about an hour. Very useful for me. Good luck to you. lisa


7-year-old pulling out her eyebrows

April 2010

My 7-year old daughter recently started pulling all her eyebrows. She became self-conscious after a friend said that she had a uni-brow. We initially thought it was an isolated incident, but she is starting to pull out the hair that are growing back. Any advice and/or recommendation for a professional who specializes in trichotilllomania would be appreciated. We've tried some supportive discussions and behavior modification techniques, but they don't seem to help. concerned mom


Check out the TLC website, join the free message board - lots to learn about trich and it is a great support group. www.trich.org anon


I also did this at one point. I had pretty dark bushy eyebrows and I remember feeling empowered when I realized that I could pull out the hair. My parents told me that once I let it grow in they would bring me to a professional to shape them nicely and they did bring me on a kind of ''spa'' day where I got them shaped, nails done, etc. I thought the whole thing was a lot of fun and she taught me to do just a little myself. After that I never pulled on them again. anon


Hi, This may sound off the wall, but aside from behavioral therapy -- which seems to have limited results for most people with Trich -- there is one medical/supplement emerging with real (reputable, peer reviewed medical journals and associated studies) backing N-Acetyl L- Cysteine as something that can significantly curb the urge to do this.

You can get it over the counter at places like GNC (called ''NAC 600'') -- and I think that is doesn't have much at all in the way of side effects to worry about. You should do you own research on it, but given the seemingly low risk, if you can get your daughter to swallow two capsules a day and it takes the edge off this for her -- I would wholeheartedly endorse it. I know it can be debilitating emotionally for people and I would hate to see it cause unnecessary angst for your daughter. I was super skeptical of it working myself -- having tried many other approaches, but have found it to be something of magic bullet (at least for me). Best of luck! Worth a try


For anyone struggling with trichotillomania (hair-pulling) or related Body-Focused Repetitive Behaviors like skin-picking, nail-biting, cheek biting, etc...

I can't recommend strongly enough that you check out www.trich.org for the Trichotillomania Learning Center. They're the only organization in the world dedicated to folks struggling with these disorders, and they've led the charge making great strides in recent years to create resources and work towards a cure.

The TLC website has lots of resources. If you are able to join, they'll send you hard copies of even more info, including a list of local providers (which is something you specifically requested in your post).

TLC is based in Santa Cruz. They host an annual conference and retreat, held in a various US locations. The retreat is happening this summer on the east coast, next year's conference is expected to be in SF.

If you have the resources for you and your daughter to attend the retreat, I can't recommend it highly enough. It's for both adults and kids, and there are lots of parents there with their children. The kids have a really great time, getting to be with other children who have similar struggles and where the pressure is off and they don't need to hide. It has the potential to be a life-changing experience, and you'll come home with loads of information and perspective.

Take care, and remember that it's possible your daughter really can't stop herself from pulling - if she could stop she would stop, so be gentle with her, and with yourself, since it's no one's fault. Good luck! Rahel


3-year-old is pulling out his hair

Oct 2004

Can anybody give me some advice on hair pulling, I have a 3 year old who's been pulling hair for the last year, and it's getting real bad. I have started to hold his hands and tell him no and to stop because it hurts. and i also have swatted him on the side of his leg, but I think it hurts me more than it does him. He attends pre school ans pulls hair 3 to 4 times a day everyday! help


A few months ago I read a column in the paper by a child psychologist about hair pulling. I was impressed with his answer to a family who's little girl was pulling her hair...He said tell the child she may pull her hair, but she has to go into the bathroom to do it. She can stay in there as long as she wants and pull as much as she wants to, but she can only pull her hair in the bathroom...that is her hair pulling place.Not a punishment, just her place to pull her hair. Apparently this worked well for this family. The girl stopped pulling her hair within a week and her bald spots filled in with new and healthy hair.

THe parents stopped pleading and giving any attention to the hair pulling, except to remind the child to go into the bathroom. The point being that the hair pulling was getting so much attention for the child, that why should she stop pulling...even negative attention is acceptable when you really want attention. If you thnk this might help you, you'd have to ask the teachers at your son's school to help you out on this...same thing, if he wants to pull his hair at pre-school he has to go into the bathroom, or into a particular corner or part of the room, alone to do it. Good luck. anon


Hair pulling (trychitilomania--sp?) may have a neurophysical component and/or be situationally induced by something in your child's home and/or school life. At any rate, hair pulling is considered a behavior of anxiety. I would urge you not to slap your child's thigh or do anything punitive. It is frustrating as hell (my daughter has a friend who does it--they are adolescents--and my daughter used to be irritated by it (and want to smack her friend's hand) until I had my daughter read about the condition). The child, by the way, is being treated, successfully, with cognitive behavior therapy. I sympathize but urge you not to be punitive, mentally or physically. Your kid can likely not help him/herself. Meds and therapy seem to work around this one. Good luck


4-year-old plucks her hair out and eats it

Dec 2002

A 4year old girl in our family plucks her hair out and eats it. She has never had a haircut but is completly bald. There is more to her behavior than just pulling her hair out but I will not get into it. It seems to me that this behavior needs some attention. Does anyone have anything to say about it? Please help. worried relative


This condition is called Trichotilomania. You can surely find information on the web. It is treatable. Good luck


It's called trichotillomania and it's a treatable, obsessive- compulsive type disorder. There's a place in the South Bay, Santa Cruz maybe?, dedicated to helping people with it. Their web address is http://www.trich.org . Get her some help while she's young; maybe it'll be easier to deal with. anon


Her condition is called tricatellamania (sp?)...sorry, don't know how to spell it. I have it too and never got treated for it and wished that i did. I had it since I was 15 years old. I've heard that it is more common in women than in men, and it is usually associated with some kind of childhood traumatic experience. I've had some bad experiences from my childhood, but I never talked to a psychiatrist about it to know wether or not it is related. Apparently there is a specific medication that helps with it. One of the symptoms in older children and adults is shame and embarrasment. That is why i haven't seeked out help. I strongly encourage you to speak up or seek help for this child. It could be a sign that something very stressful or traumatic is going on for her. It shouldn't be ignored. My condition was ignored when I was young...a big mistake. I now have areas of my hair that will never grow back. Anon


Your child needs to see a pediatric psychologist. Another possibility would be going to a Pediatric Dermatologists first. These kids usually respond to medical therapy for a six month period of time. I had one patient who stopped pulling out her own eyelashes and hair and then even pulled out the hair and ate it of her Barbie. It is correctable. Don't Worry But get it Treated


I have a VERY similar sort of behavior. There is actually a name for it, trichotillomania. You can find out more about it at http://www.trich.org/ . It's basically a form of impulse control/obsessive compulsive disorder. It can be associated with other similar disorders/habits (for example, I also compulsively doodle, destroy napkins and roll them into little balls, chew pens, etc.) As with other disorders of the type the typical treatments are cognitive behavior therapy and drugs. The girl's parents would do well to take her to a psychiatrist with experience in this type of disorder anon


Hair pulling or plucking anywhere on the body is also called Trichotillomania and is a subset of Obsessive Compulsive Disorder (OCD), and has to do with altered brain chemistry and possibly genetics. You can get a vast amount of information about it by searching with that word at www.Google.com - for example www.trich.org and others Also there is a yahoo group for people with Trichotillomania that you could join and ask questions. I found then just now for you, again by using Google groups.yahoo.com/group/Trichotillomania-friends/ ''A community to support people with trichotillomania (compulsive hair pulling). We aim to discuss, help and mutually support each other in our efforts to understand and control this impulse control disorder. We are a group of lay people who have lived with this difficult condition for some time. Anyone who has trich or has a relative or friend with trich is welcome to join. We aim to include all opinions and age groups and talk on issues mainly related to trich but also sharing some of our other lives.'' Good luck! Christine