Trichotillomania (Hair-Pulling Disorder) in Children and Adolescents


ICD-10 code: F63.3

Trichotillomania (hair pulling disorder) is part of a cluster of diagnoses called the obsessive-compulsive and related disorders.  Obsessive-compulsive and related disorders are a group of psychiatric conditions that include:

  • Obsessive-compulsive disorder
  • Body dysmorphic disorder
  • Hoarding disorder
  • Trichotillomania
  • Excoriation (skin picking) disorder

These disorders are characterized by the occurrence of repetitive behaviors, often called compulsions.  Individuals with obsessive-compulsive disorder might engage in compulsive behaviors such as excessive washing, checking, arranging, or counting.  Individuals with body dysmorphic disorder might engage in frequent checking of their appearance in the mirror, or excessive grooming-related behaviors.  Individuals with hoarding disorder may engage in excessive acquiring of objects, combined with a strong need to save items.  Individuals with trichotillomania engage in excessive hair pulling, and individuals with excoriation disorder engage in excessive skin picking.

In some cases, the obsessive-compulsive and related disorders are also characterized by intrusive, unwanted, or distressing thoughts, called obsessions, which come to mind again and again.  People with obsessive-compulsive disorder might have obsessive thoughts about dirt or germs, thoughts of harming others, fears of making mistakes, or distress about things being out of order.  People with body dysmorphic disorder have repetitive, negative thoughts about their own appearance.  However, people with certain other obsessive-compulsive and related disorders (such as trichotillomania or excoriation disorder) often do not experience obsessive thoughts.

What is trichotillomania (hair pulling disorder)?

Trichotillomania is a psychiatric disorder that usually begins in late childhood/early puberty. Although trichotillomania was previously believed to rarely occur in children and adolescents, more recent estimates of the prevalence in older adolescents and young adults range between 1% and 3.5%.

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Understanding Trichotillomania (hair pulling disorder)

Trichotillomania severity can range from mild to very severe.  In severe cases, trichotillomania can lead to severe distress or embarrassment and/or health complications, such as damage to teeth from biting the hair or abdominal pain or injury from trichobezoars (masses of hair in the digestive system).

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How is trichotillomania (hair pulling disorder) treated?

Trichotillomania is treatable.  The Trichotillomania Learning Center (TLC) and the Society of Clinical Child and Adolescent Psychology has published guidelines on the treatment of trichotillomania.



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