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Home › Articles › Special Needs › Hair Pulling

Hair Pulling

What Happens When a Child Can't Quit?

By Teri Brown

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"Hair pulling doesn't hurt a compulsive hair puller," Rohrer says. "In fact, most report the behavior as soothing. Hair pullers pull out the hair from their scalp, eyelashes, eyebrows, pubic areas, legs, armpits and create noticeable bald patches. Some hair pullers eat the root [bulb] and even chew and swallow the hair. Some follow other habitual or ritual behaviors such as brushing hair against a cheek, for example. Many pull uncontrollably for hours each day."

Unanswered Questions
Christina Pearson is the executive director of The Trichotillomania Learning Center in Santa Cruz, Calif. She says that at this moment there is no clear-cut answer as to why children develop TTM.

"There are several hypotheses floating around, but not enough empirical data to really answer this question scientifically," Pearson says. "That said, it does seem that the children who develop TTM are, for the most part, quite intelligent, hyper-sensitive to stimuli, easily emotionally overwhelmed and may develop the behavior to help 'regulate' internal states. Patterns of pulling widely vary, but there are some general times that are often triggers for pulling, such as being tired, watching TV, riding in car seats, waking up or going to sleep, etc."

Pearson says it seems as if there may be two types of trichotillomania. "Baby Trich" or "Toddler Trich" seems to be more benign, more self-regulating and diminishes over time. For children who develop pulling before the age of 5, many seem to simply develop out of the need to pull.

"When TTM starts around puberty or pre-puberty, the possibility of long-term chronic TTM is much higher, but again, not a definite," Pearson says.

Treatments
As far as treatments for children go, Pearson says that cognitive behavioral therapy with a provider familiar with treatment is probably the most accepted for of treatment in the professional community. There are currently no medications that have been approved for TTM by the FDA. So if a doctor prescribes a medication, it is an "off label" use.

"In pharmaceutical studies, no medication has proven that effective for TTM as of yet, although some people do experience some benefit," Pearson says. "The problem is, often when there is initial benefit from a medication, the effect seems to wear off over time."

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