Compulsive Hair Pulling

Many children deliberately pull out bits of hair once in a while. Such behavior is similar to other self-soothing rituals such as stroking a lock of hair or a favorite stuffed animal. Occasionally, however, hair pulling turns into a compulsive habit. Children who fall into this habit can end up plucking out enough hair to leave bald spots on the scalp and in the eyebrows.

WHAT CAUSES COMPULSIVE HAIR PULLING?
Causes vary from child to child, but compulsive hair pulling almost always is related to anxiety. Whether it's the result of family troubles, difficulties at preschool and play, or more deeply seated emotional conflicts, anxiety upsets a child's sense of well-being. Engaging in hair pulling helps some children cope with this discomfort.

WHEN SHOULD I SUSPECT THAT MY CHILD IS PULLING OUT HAIR COMPULSIVELY?
Patchy bald spots in easy-to-reach areas of the scalp are often the first clue. You may also observe the child in the act of pulling out hair. If the child complains of stomachache, she may also be swallowing strands of scalp hair. Hair loss alone, however, does not necessarily signal hair-pulling behavior. Other scalp ailments also can cause patchy hair loss. (For instance, ringworm.)

IS MEDICAL ATTENTION NECESSARY?
Yes; professional attention is usually needed to help compulsive hair pullers overcome their anxiety and find better ways to cope with stress. The first step is a visit to a pediatrician, who will examine the child and try to identify the stresses underlying the problem. Next, the doctor may refer the family to a child psychiatrist, psychologist or some other trained counselor.

WHAT TREATMENTS ARE AVAILABLE?
Mild cases may respond to simple behavioral intervention. Parents may, for example, be shown how to set up a system to reward the child for every day she does not engage in hair pulling. The pediatrician may also apply a coating substance (collodion) to the child's bald patches to stop further hair pulling.

Some types of counseling is usually recommended to address underlying sources of anxiety. Such counseling generally involves the family and begins with an evaluation of the child's interactions with parents, teachers, siblings and peers.

GETTING HELP
Call your pediatrician if:

• You see your child pulling hair from her scalp on a daily basis

• You notice bald patches on your child's scalp, particularly around the hairline

• Your child keeps pulling out her hair in spite of your attempts to discourage it

• Your child repeatedly swallows hair after pulling it out

Excerpt from THE DISNEY ENCYCLOPEDIA OF BABY & CHILD CARE, © 1995 DSH Communications, Inc. This material is based on current medical research and, to the best of the editors' knowledge and understanding, is accurate and valid. However the reader should not use information contained in this material to alter a medically prescribed regimen or as a form of self-treatment, without seeking the advice of a licensed physician.