Pediatric Trichotillomania Follow-up

  • Author: Cynthia R Ellis, MD; Chief Editor: Caroly Pataki, MD   more...
 
Updated: Apr 16, 2012
 

Further Outpatient Care

  • Consult mental health professionals for further assessment and possible treatment modalities.
  • A record of hair pulling and/or the saving of plucked hairs may be required to confirm a diagnosis of trichotillomania. However, use caution when depending on patient self-reporting and/or records from children, because some may engage in trichophagia and consume pulled hairs or pluck hairs in privacy to hide the severity of the disorder.
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Complications

  • Treating trichotillomania in children may be difficult because of the low reliability and validity of self-report.
  • Children often pull their hair in private.
  • Trichotillomania can result in alopecia, hair abnormalities, and, if the pulled hair is ingested, trichobezoar formation with associated medical complications (see Clinical).
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Prognosis

  • Trichotillomania can become a chronic and persistent condition of hair pulling. Specifically, symptoms of trichotillomania can persist for weeks to decades. Therefore, comprehensive treatment planning is critical and may require consultations with mental health professionals.
  • Hair pulling that occurs in young children may be described more accurately as a short-term habit disorder.
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Patient Education

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Contributor Information and Disclosures
Author

Cynthia R Ellis, MD  Director of Developmental Medicine, Associate Professor, Department of Pediatrics and Psychiatry, Munroe Meyer Institute for Genetics and Rehabilitation, University of Nebraska Medical Center

Cynthia R Ellis, MD is a member of the following medical societies: Nebraska Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Holly Jean Roberts, PhD  Assistant Professor, Pediatrics, Munroe-Meyer Institute, University of Nebraska Medical Center

Holly Jean Roberts, PhD is a member of the following medical societies: Autism Society of America, National Association of School Psychologists, and Psi Chi

Disclosure: Nothing to disclose.

Connie J Schnoes, MA, PhD  Psychologist, Director of Training, Supervising Practitioner, Father Flanagan's Boys' Home, Boys Town

Disclosure: Nothing to disclose.

Specialty Editor Board

Chet Johnson, MD  Professor and Chair of Pediatrics, Associate Director, Developmental Pediatrician, Center for Child Health and Development, Shiefelbusch Institute for Life Span Studies, University of Kansas School of Medicine; LEND Director, University of Kansas Medical Center

Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Carrie Sylvester, MD, MPH  Senior Child and Adolescent Psychiatrist, Sound Mental Health

Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD  Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

References

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A close-up picture of typical trichotillomania shows a combination of newly growing young hair, broken shafts, comedolike black dots, empty orifices, and vellus or intermediate hairs.
Typical geometric shape of trichotillomania in a 7-year-old boy. Smooth baldness of the scalp surface at this age is rare.
 
 
 
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