Compulsive hair pulling can be difficult to identify in children. It causes frustration, embarrassment, and shame not only for the child but also for the parent.
When does it start?
The typical age of onset for trichotillomania in children tends to coincide with the onset of puberty. Since the internal hormonal changes can be difficult to detect, a child could start puberty as early as 8 years old, which is why the typical age of onset for trich tends to be between ages 9 and 13. Some research links trichotillomania onset and severity with sex hormones, especially in girls which means the changing levels of estrogen, progesterone, and adrenocorticotropic hormone can create an environment ripe for developing trich or other BFRBs.