TLDR Children with trichotillomania often pull hair from their scalp, and parents may not notice; stress can trigger it, and asking detailed questions helps in diagnosis and treatment.
The document summarizes a retrospective study of 33 children diagnosed with trichotillomania at a tertiary children's hospital, revealing that scalp involvement was most common and that only 51.5% of parents noticed their child's hair pulling. It was found that triggering factors such as physical appearance, family, school issues, and illness played a role in 48.5% of the cases. The study emphasizes the need for clinicians to ask specific questions to diagnose trichotillomania, especially since hair pulling may occur during sleep and may not be noticed. The document also discusses the importance of considering parental behavior and stressful triggers in the onset of the condition. It describes diagnostic tools like the hair pull test and dermoscopy and highlights the challenges in treatment, including parental acceptance and confidence in management plans. Behavioral therapy is noted as a promising treatment, and pharmacotherapy has had mixed results. The study advocates for the '5Ws and 1H' questioning approach to improve understanding and treatment of trichotillomania in children.
245 citations,
March 2012 in “Journal of The American Academy of Dermatology” Dermatoscopy is useful for identifying different hair and scalp conditions and can reduce the need for biopsies.
69 citations,
August 2006 in “Behavior Therapy” Group behavior therapy reduces hair-pulling symptoms more than supportive therapy but has limited long-term effectiveness.
40 citations,
May 1999 in “International Journal of Dermatology” Early diagnosis and treatment are crucial to prevent permanent hair loss from scalp trauma.
417 citations,
March 1991 in “American Journal of Psychiatry” Most adult chronic hair pullers are women who started in their early teens, often have other mental health issues, and may pull hair due to underlying psychiatric conditions.
January 2016 in “Springer eBooks” The conclusion is that using the 5W1H method can improve diagnosis and management of childhood hair-pulling disorder.
July 2018 in “Elsevier eBooks” The most common cause of hair loss in children is tinea capitis, followed by alopecia areata and telogen effluvium.
8 citations,
September 2021 in “Skin appendage disorders” Trichotillomania treatment is most successful with a mix of behavioral therapy, medication, and social support.
May 2021 in “Pakistan Journal of Medical and Health Sciences” Trichogram is useful for diagnosing hair disorders, but newer, non-invasive methods like trichoscopy are becoming more popular due to their sensitivity and ability to monitor treatment responses.
Afro-textured hair is more fragile and prone to certain scalp conditions, requiring careful treatment and more research for effective management.
