A Child with Nonscarring Alopecia

The document detailed a case of a 4-year-old girl diagnosed with trichotillomania, a psychiatric disorder with a lifetime prevalence of less than 1%, after she was observed pulling her hair during an office visit. This condition, which has a female predominance, can start at any age and may resolve on its own if it begins early, but can become chronic and associated with other psychiatric disorders if it starts during adolescence. Characterized by recurrent hair pulling, tension before the act, and relief afterwards, treatment options include selective serotonin reuptake inhibitors and cognitive behavior therapy, particularly habit reversal therapy, although no medication is specifically approved for trichotillomania. The document emphasized the necessity of a thorough workup for alopecia to ensure an accurate diagnosis.