Some children may use hair pulling as a coping mechanism during stressful times. When this action becomes compulsive, it may be trichotillomania.

While many children play with their hair, consistent and obsessive pulling might suggest childhood trichotillomania. This mental health condition involves recurrent, irresistible urges to pull out hair from the scalp, the eyebrows, the eyelashes, or other areas, leading to noticeable hair loss.

But with patience and supportive strategies, children can manage and even overcome trichotillomania.

For some children, hair pulling can serve as a coping mechanism during stressful times. This behavior might offer a temporary sense of relief or distraction from overwhelming emotions or situations.

The act of pulling hair can create a physical sensation that diverts attention away from emotional pain. It might also provide a feeling of control in situations where your child might otherwise feel powerless or anxious.

It’s common for people with trichotillomania to have one or more comorbidities (conditions that occur at the same time), such as obsessive-compulsive disorder (OCD), depression, or attention deficit hyperactivity disorder (ADHD), but these are not a requirement for diagnosis.

While some people may experience trichotillomania without accompanying mental health conditions, it has been associated with several other conditions.


Trichotillomania is often considered part the spectrum of OCD-related disorders because it involves repetitive behaviors.

Some research in twins has suggested genetic links between trichotillomania and other OCD-related conditions, such as excoriation (skin picking) disorder.

Tic disorders

Trichotillomania may be linked to tic disorders such as Tourette syndrome.

The authors of a 2020 research review suggest that trichotillomania may be most related to tic disorders, although it’s currently in the OCD category in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision.

This association may influence treatment options for trichotillomania.

Anxiety disorders

Trichotillomania often co-occurs with anxiety disorders such as social anxiety disorder, generalized anxiety disorder, and panic disorder. It’s also commonly linked with feelings of anxiety or distress that precede the hair-pulling behavior.

In one 2017 study involving 530 adults with trichotillomania, about 28% of the participants also had an anxiety disorder.

The percentage may be similar in children. The authors of another 2017 study cite older studies in which 24–30% of children with trichotillomania reported anxiety with their pulling behaviors.

Depressive disorders

Depressive symptoms are fairly common with trichotillomania. Selective serotonin reuptake inhibitors (SSRIs) are considered a first-line treatment for trichotillomania in adults and may also be helpful for children.

Adults who have trichotillomania in addition to both depression and anxiety have the most severe symptoms. This may be true for children as well, though more research is needed.


Some studies suggest a potential association between ADHD and trichotillomania, although the link is not as strong as in the disorders mentioned above.

In one 2022 study of 308 adults with trichotillomania, researchers found that 15.3% of the participants also had ADHD.

It’s important to note that compulsive hair pulling isn’t always classified as trichotillomania. For hair pulling to be diagnosed as trichotillomania, it must cause significant distress or impairment in daily functioning.

Supporting a child who is stressed involves creating a nurturing environment and offering tools to help them manage stress effectively. You can support change in a variety of ways, but the approach will likely vary depending on your child’s age.

Emotional support

  • Stay calm: Approach the situation calmly and without judgment. Avoid getting frustrated or angry, as this could make your child feel ashamed or embarrassed.
  • Talk with your child: Have an open and honest conversation with your child about their hair pulling. Encourage them to share their feelings and any triggers that might be causing this behavior.
  • Engage in active listening: Pay attention to your child without judgment. Validate their feelings and let them know you’re there to support them.

Immediate changes

  • Identify triggers: Help your child recognize triggers that prompt hair pulling, such as stress, anxiety, or boredom. Once you’ve identified the possible triggers, work on finding alternative coping mechanisms or distractions.
  • Use barriers or distractions: Consider using gloves, hats, or fidget toys to create physical barriers or distractions that discourage hair pulling.
  • Limit stressors: Identify and minimize stressors when possible. For instance, if certain activities or situations consistently cause your child stress, find alternatives or ways to relieve the pressure.
  • Encourage positive reinforcement: Praise your child when they resist the urge to pull their hair. Positive reinforcement can be a powerful motivator for behavior change.

Long-term interventions

  • Teach stress-management techniques: Practicing relaxation techniques such as deep breathing, mindfulness, and visualization can help your child calm their mind during stressful moments.
  • Establish routine and predictability: Maintain a consistent routine at home. Predictability and structure can provide a sense of security, especially during stressful times.
  • Encourage hobbies and creativity: Engage your child in hobbies or activities they enjoy. Drawing, writing, music, or any other creative outlet can help relieve stress.
  • Monitor progress: Keep track of your child’s progress and setbacks. Celebrate small victories and remain patient, as overcoming trichotillomania can be gradual.

Early intervention and a personalized treatment approach, accounting for your child’s needs and any co-occurring conditions, can greatly enhance the management of trichotillomania.

Treatment for trichotillomania in children typically involves a combination of approaches:

  • Behavioral therapy: Cognitive behavioral therapy and habit reversal training are often used for trichotillomania. These therapies can help your child identify triggers for hair pulling and teach alternative behaviors to replace the urge.
  • Supportive counseling: Individual or family counseling can help your child understand and manage emotions related to hair pulling.
  • Medication: In some cases, doctors might prescribe medications such as SSRIs to help manage comorbid symptoms, particularly if your child has an underlying anxiety or mood disorder.

Childhood trichotillomania requires patience and understanding. With early intervention, tailored therapies, and a supportive environment, many children learn to manage and overcome this condition.

If your child is pulling out their hair and causing hair loss, you can help them manage and overcome this behavior by approaching the situation calmly, seeking professional guidance, and creating a supportive environment.