Trichotillomania: Treatment

Psychotherapeutic: Trichotillomania is treated primarily through behavioral therapy. Cognitive behavioral therapy (CBT), which helps children become more aware of their hair pulling, is very helpful. Through CBT children can come to recognize the emotions and triggers involved in their hair pulling. Sometimes something as simple as wearing loud, dangling bracelets can make kids more self-aware.

After learning to recognize the habit, children can then begin habit reversal therapy. Some doctors recommend tricks that make hair pulling more difficult. For example, wearing bandages around the fingers and nails can make it harder to pull out hair, as does wearing hair pulled back or under a hat. For kids who enjoy the sensation of playing with the hair after it has been pulled, rolling a paper clip or playing with a textured pencil topper can help recreate the desired sensation and keep the hands distracted. Some kids in treatment carry kits around with bandages, paper clips, hair ties and other items that will help them.

Pharmacological: Medication is usually not the first choice in treating trichotillomania, although children may be prescribed antidepressants like SSRI’s while they participate in behavioral therapy.