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Trichotillomania treatment recommendations

  • anonymous Asks ...

    My daughter has Trichotillomania (she is a hair puller). My daughter is 15 and she was able to hide it from me for a long time. I would see her pulling her hair while watching TV but I never knew it was a serious problem, I just thought it was a bad habit and I would scold her to stop. I have only known about it that it was a serious problem for a few weeks. I took her to our family doctor and he said if she couldn’t stop doing it on her own he might prescribe antidepressants to her. I do not want her to start off on drugs so young. I have a solution but my husband thinks it is wrong. I would like to ask you about it. What if we just shaved her head completely and kept it shaved for long enough for her to break her bad habit? I know this sounds extreme but I think she could pull it off looks wise and she could think of a reason to tell her friends and it would be better than starting her off on a lifetime of needing drugs.

  • Dr. Lani Chin Says ...
    Dr. Lani Chin

    Thank you for your post.  Your daughter is lucky to have you on her side.

    First and foremost, I would recommend individual and family therapy for your daughter.  Trichotillomania is an impulse control disorder.  As such, you daughter is likely having a difficult time with coping.  She has found comfort in pulling out her hair and probably finds the behavior quite soothing.  It would benefit her greatly to learn some new coping mechanisms and individual therapy can be the perfect setting for that.

    I want to address your question.  You asked about shaving her head.  Is this something that she is on board with?  If you shave her head without her consent, you will likely exacerbate the problem.  Most of the time, hair pulling is about feeling in control of something.  If you shave her hair and she doesn't want you do that, you will make the problem worse and her symptoms will likely increase.  Additionally, since trichotillomania is an impulse control disorder, she will likely find another maladaptive way of coping with her emotions.

    You also state feeling concerned that your daughter will be "on a lifetime of needing drugs."  This is a common misconception about medication.  An anti-depressant can be taken on a short term basis for your daughter to feel better and begin to address the problems that are contributing to her symptoms.  This is not a guarantee that she will need medication for the rest of her life.  Again though, if your daughter begins therapy, she will learn coping skills that will likely decrease the need for her to be on medication.

    Hope I've answered your questions.  Good luck to you and your daughter.

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