A Childhood Case of Trichotillomania Associated with Body Dysmorphic Disorder and Stigmatization Due to Outstanding Red Hair

The document describes the case of a 12-year-old girl with bright red hair who was referred for hair loss and diagnosed with trichotillomania (TTM), a hair-pulling disorder, and body dysmorphic disorder (BDD), due to stigmatization from her hair color. The girl had been called "carrot head" by schoolmates, leading to increased hair loss when she was alone. Clinical and dermoscopic findings, including the absence of exclamation mark hairs and the presence of black dots and coiled fractured short hairs, supported the diagnosis of TTM, avoiding the need for a traumatic scalp biopsy. The case highlights the overlap between TTM and BDD, with hair color contributing to the psychopathologies, and suggests that stigmatization due to physical attributes can have significant psychological impacts.