How to Identify Trich in Children

Compulsive hair pulling can be difficult to identify in children. It causes frustration, embarrassment, and shame not only for the child but also for the parent.

When does it start?

The typical age of onset for trichotillomania in children tends to coincide with the onset of puberty. Since the internal hormonal changes can be difficult to detect, a child could start puberty as early as 8 years old, which is why the typical age of onset for trich tends to be between ages 9 and 13. Some research links trichotillomania onset and severity with sex hormones, especially in girls which means the changing levels of estrogen, progesterone, and adrenocorticotropic hormone can create an environment ripe for developing trich or other BFRBs.

Another thing to consider is that if your child demonstrates hair pulling behaviors before the onset of puberty, there is a chance that puberty will cause the behaviors to disappear. Sometimes, in young children, hair pulling can indicate other things such as tic disorder, autism spectrum disorders, impulse control disorders, or a response to trauma. Also, in some cases, developmental changes during childhood into adolescence can result in hair-pulling behaviors disappearing or worsening. Therefore, parents should keep an eye on their child’s behaviors to determine if there is a pattern to them and then discuss it with a mental health professional.

Signs and symptoms

The symptoms of trich in children are the same as in adults. However, children may not be able to explain their behaviors if they fall into the automatic pulling category. For example, if your child comes home from school with patches of hair picked out on their scalp and cannot provide an explanation, they may be doing it while they are zoning out in class. This means they are not consciously aware they are doing it. Therefore, yelling at them or scolding them or asking them repeatedly to remember is not going to yield results.

If they pull in a more focused style, they may be doing so in response to anxiety or stress as an emotional regulation tactic. If that is the case, they may not be able to state the reason or identify the trigger. However, careful observation can help parents establish some cause and effect. For example, if your child appears anxious about something at school around the same time you notice them pulling, perhaps they are doing so in response to the stress. Recognition of these patterns can help a clinician with early interventions for your child.

What to do

If you suspect your child may be dealing with compulsive hair pulling, understand that they may be frightened about what is happening to them. They may feel bad for doing it and not know how to stop, which increases their levels of anxiety and shame.

Here are some steps to take:

• Let your child know repeatedly and often that you love them.
• Do not harp on your child to stop pulling, and do not make their behaviors the focus of every day.
• Engage them in problem-solving and guide them to using their own creative strategies.
• Get your child into therapy early. Early interventions result in the most success.
• Help your child come up with creative ways to keep anxiety and stress low as well as how to keep their hands busy.
• Ask about engaging your child in a peer support group either in person or online.
• Celebrate your child’s successes, no matter how small they are.