Baby Hair Pulling

Trichotillomania is the medical term for a condition that describes young children and adolescents who pull out the hair from their scalp, eyelashes, eyebrows, or other parts of the body, resulting in noticeable bald patches. It is estimated to affect one to two percent of the population, or four to eleven million Americans, and often begins in childhood and adolescence. Although the symptoms range greatly in severity, location on the body, and response to treatment, most children with Trichotillomania pull enough hair over a long enough period of time that they have bald spots on their heads (or missing eyelashes, eyebrows, etc.) pubic, or underarm hair.

Babies: 1 month to 2 years

Hair pulling at this age is usually a self-comforting habit. It often goes along with thumb sucking. The baby reclines with thumb or fingers in the mouth and twists his/her own or his mother's hair with the other hand. The child finds this relaxing and usually engages in the behavior before falling asleep or when he/she is distressed.

Toddlers: 2 to 5 years

When a child has been pulling at their hair since infancy, the toddler will be in the habit of doing it without thinking. At around the age of three, children can tell when parents are reacting to what they do. If parents get worried or upset when their child pulls at his hair, he soon will learn how to get parental attention with this behavior. Hair pulling is used by the toddler as an effective addition to kicking and screaming during a tantrum. Younger children usually twist hair and the older ones pluck at their hair.

Onset and Prevalence

Despite its occurrence in up to 3.4% of adults, hair-pulling disorder or trichotillomania (TTM) is often under-diagnosed and inappropriately treated, according to a panel of experts presenting at the recent APA meeting in Philadelphia.  The estimated lifetime prevalence in adults ranges between 0.6% and 3.4%. TTM seems to have a bimodal age of onset, he said. The typical onset of TTM is between ages 9 and 13. This group usually has a more chronic form of the disorder and a “more difficult response to treatment,” Woods added. “Baby trich,” with onset between 18 months and 4 years, Woods said, is believed to be short-term, related to attachment issues and related to covarying oral habits.

Will Hair Regrow?

One of the biggest concerns for trichsters and particularly parents if babies who pull is hair re-growth. It is also one of the most difficult questions to answer. Re-growth will largely depend on the duration and intensity of the pulling. There have been cases where people who have pulled for 30 years have achieved full coverage once they have become pull free, whilst other have permanent damage after 5 years of pulling. First lets look at the structure of the hair. Keratin, the same strong protein that makes fur and feathers in animals, and the outermost layer of skin and nails in humans, is the main protein composition of our hair. Hair is continually shed and renewed by the alternating cycle of growth, rest, fallout, and renewed growth. Each follicle follows this cycle independently of others, so the total number of hairs normally remains consistent. On average 50 -100 hairs are shed per day. This does sound a lot but when you consider the total number of follicles on your scalp is around 150,000, it is a very small amount. When you pull a hair the hair follicle will try and repair any damage that has occurred. The human body has a remarkable way of repairing itself but this can take some time. If you pull a hair and the root is not pulled out this means that the hair is in its resting phase, however if you pull a hair with the root attached the hair is in the active phase which means it is actively growing. If you pull part of the root out this can damage the hair follicle. If you pull the hair and the whole follicle comes out with a red tip, you have just detached the blood supply and muscle. This is permanent damage. This means that the hair will not grow back. It may be that babies do not have the dexterity to pull follicles from the roots so there is a good chance that hair will regrow. However, it is best to seek the help of a professional as soon as you are aware your child is a chronic hair puller. One should also note that different areas have different speeds of hair growth recovery. For example full recovery for normal hair on the scalp can take 2-6 years. When damage has been caused to the scalp of the follicles the recovery time could take significantly longer.