Trichotillomania. This is a form of alopecia (hair loss) that is caused by the child’s twisting or pulling of their own hair. This cause of hair loss is usually easy to recognize. There is often, but not always, a parental awareness of hair-pulling behavior sometimes while the child is studying or watching television or at bedtime. The area of hair loss is usually asymmetric and follows an irregular pattern. Examination of the involved area reveals hair that is broken off at different lengths. There is never the total hair loss of alopecia areata or the scaling and erythema of tinea capitis. In most cases, trichotillomania is evidence of an innocent and benign habit that is best compared to nail biting. However, trichotillomania may sometimes be evidence of more severe emotional distress or a manifestation of obsessive compulsive disorder. In addition, children who swallow their plucked hair may develop a gastric trichobezoar (hair ball) that may need surgical intervention.
Color Atlas of Pediatric Dermatology Samuel Weinberg, Neil S. Prose, Leonard Kristal Copyright 2008, 1998, 1990, 1975, by the McGraw-Hill Companies, Inc. All rights reserved.
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