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Child and Adolescent Services>>
Child and Adolescent Disorders That We Treat>>
Trichotillomania in Young Children and Adolescents
Trichotillomania
(Hair Pulling)
Trichotillomania (TTM) causes young children and adolescents to pull out
the hair from their scalp, eyelashes, eyebrows, or
other parts of the body, resulting in noticeable bald
patches. It is estimated to affect one to two percent
of the population, or four to eleven million Americans,
and often begins in childhood and adolescence.
How
Do I Know If I Have Trichotillomania?
Although the symptoms range greatly in severity, location
on the body, and response to treatment, most people
with Trichotillomania (TTM) pull enough hair over a long enough period
of time that they have bald spots on their heads (or
missing eyelashes, eyebrows, pubic, or underarm hair),
which they go to great lengths to cover with hairstyles,
scarves or clothing, or makeup. The persistence of
the compulsion can vary considerably: For some people,
at some times, it is mild and can be quelled with
a bit of extra awareness and concentration. For others,
the urge may be so strong that it makes thinking of
anything else nearly impossible.
What Are Other Body Focused Repetitive Behaviors?
Skin Picking (aka, neurotic excoriation or dermatillomania). Characterized by repetitive picking of one's skin to the extent it causes damage. Individuals may pick at skin variations such as moles, freckles, or blemishes. This problem can lead to infection and permanent scarring.
Nail Biting (aka, Onychophagia). Characterized by repetitive biting of one's nails and/or cuticles to the extent it causes pain or damage. This problem can lead to infection and permanent scarring.
What
Treatments Are Available?
Research into treatments for trichotillomania has grown
steadily over the past decade. Although no one treatment
has been found to be effective for everyone, a number
of treatment options have shown promise for some people
with TTM.
- Cognitive-Behavior
Therapy
Cognitive-Behavior Therapy is a form of psychotherapy
that seeks to alter behavior by identifying the precise
factors that trigger hair pulling and teaching skills
to interrupt and redirect responses to those triggers.
The specific name for the cognitive-behavioral treatment
of trichotillomania is Habit Reversal Training or
HRT. An HRT therapist will encourage hair pullers
to develop an increased awareness of the times of
day, emotional states, and other factors that promote
hair pulling, as an important precursor to being able
to control the behavior. Then the hair puller will
learn strategies to include relaxation as well as
an alternative response to pulling.
- Pharmacological
Therapy
A number of medications have shown promise in reducing
the severity of TTM symptoms. Most of these fall under
the category of selective serotonin-reuptake inhibitors
(SSRIs), which are commonly used to treat anxiety
and depression. The effectiveness of these drugs for
hair pulling ranges considerably. A small percentage
of people find these drugs stop their hair pulling
completely, while others experience no effect at all.
Still other people have found the urges to pull their
hair reduced somewhat, for varying periods of time.
If
you would like more information on Trichotillomania
in Young Children or in general, you may want to contact the Trichotillomania
Learning Center at www.trich.org.
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