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Hair Pulling Disorder (Trichotillomania)

Surprising to some, Hair Pulling Disorder (HPD) affects over 3 million people in the Unites States. Some researchers believe that this number may even be significantly higher. Although research examining the development, course, and treatment of HPD is still in its infancy, particularly with respect to children, evidence suggests that the symptoms of HPD can cause significant distress and impairment at school, work, and with family and friends.


Among children, HPD is characterized by the repeated pulling out of the child’s hair resulting in noticeable thinning of the hair or bald patches. The disorder is seen much more frequently in girls than boys, although the gender ratio discrepancy is thought to be less dramatic among children than it is for adults. The most frequently pulled from areas include the head, eyebrows, and eyelashes though pulling may occur from anywhere that hair grows. Children who pull their hair do not typically pull to make their parents angry.


Preliminary studies have suggested that cognitive behavior therapy (CBT) may be effective for the treatment of HPD in kids. For kids, CBT most often includes stimulus control (e.g., removing cues for and making it more difficulty for the child to pull), relaxation training, and habit reversal (e.g., increasing the child’s awareness of pulling and providing a competing behavior). As of yet, there are no studies to support the use of medication for the treatment of HPD in kids.

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