A Hairy Situation – Trichotillomania, What Is It?

A Hairy Situation – Trichotillomania, What Is It?

Recently a topic came up about a Mum’s experience with a child suffering from Trichotillomania, here are your questions answered.

Contributed by a specialist paediatrician from Orange

What is Trichotillomania?

Trichotillomania (pronounced trik-o-till-o-MAY-nee-uh) is a disorder characterised by repetitive pulling out of one’s own hair, leading to hair loss. It occurs in approximately 1 in 25 people and typically starts in the preschool years and also in early adolescence, affecting both males and females.

What causes Trichotillomania?

The exact cause of Trichotillomania is unknown and not well-understood. It may develop as a coping mechanism caused by stress or anxiety. It can be associated with other repetitive behaviours such as skin picking, nail biting, lip biting and cheek chewing.

What are the features of Trichotillomania?

It most commonly involves pulling of the hair on the scalp but hairs can be pulled from other parts of the body such as the eyebrows, eyelashes, arms or legs.

The person may be unaware of the habit, in which case it usually occurs when they are distracted such as watching television or studying. In some people it occurs deliberately associated with compulsive urges and anxiety that are alleviated by pulling of the hair. The severity varies greatly from one individual to another. For some individuals Trichotillomania is mild and manageable, for other it can become a debilitating problem.

The hair loss can range from mild thinning to completely bald areas. It does not cause permanent hair loss or damage to the hair follicles.

How is Trichotillomania treated?

The first step should be a review with your GP to make sure there is no other underlying cause of the hair loss.

Simple measures include the following:

  • A short haircut
  • A hairnet or cap to sleep in
  • Cotton gloves or mittens for high risk times such as when your child is tired, just before falling asleep and watching television.
  • Give your child objects to fiddle with e.g. feathers, ribbons

Other management strategies involve behavioural therapy and treatment of underlying stress/anxiety. Reassuringly a large proportion of children will outgrow the condition.

Psychology Treatment

Melissa Theobald, Clinical Psychologist from Psych Solutions says “Trichotillomania (hair-pulling disorder or TTM) involves repetitive hair pulling that can cause distress, embarrassment and can impact functioning. Children and adults can suffer from this disorder. Our Psychologists at PsychSolutions have seen a number of people present with TTM (mostly children) and the good news is there is treatment that can work. At PsychSolutions we use a combination of behavioural interventions, mindfulness training and stress management to address TTM.  With behavioural interventions we help people to learn to recognise their urges to pull their hair, avoid situations in which pulling hair is more likely and adopt new behaviours (i.e. wear gloves, fidget with a brightly coloured toy) that can be used instead of pulling hair. In addition we teach clients about mindfulness and other anxiety/stress reducing strategies. In some cases, medication can be helpful to reduce the behaviour.  With effective intervention we have found that most people can reduce the hair pulling behaviour. We have also found that in time children tend to grow out of this behaviour as they mature.”

Amorette Zielinski

Amorette is a Mum of two boys who often keep her flying by the seat of her pants and a wife to a man who is so much fun to share life with; never dull! Friends often call her a ‘connector’ because she loves putting like minded people together curating experiences for them.

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