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Paediatric Trichotillomania – An Anecdote of A Six-Year-Old Trichster

Introduction: Trichotillomania (TTM) is a form of traumatic alopecia caused by an irresistible compulsion to pull one’s own hair. Early-onset TTM is when the age of onset is between 2 and 10 years. This form is commoner in boys and tends to remit spontaneously with age. Other forms of nonscarring alopecias such as alopecia areata and tinea capitis to be excluded.In this case report, we discuss about a 6 year old boy with trichotillomania. Case: A 6 year old boy was brought by his mother to paediatric OPD with complaints of uneven loss of hair in right frontal region of the scalp noted for past 6 months. The child gave the history of irresistible urge to pull his own hair. Dermoscopic findings revealed fractured hairs of uneven length consistent with TTM and other common conditions such as alopecia areata and tinea capitis were ruled out. Psychological assessment was done. Behavioural and occupational therapy started. Visual feedback techniques and diversion activities were taught to mother of the child. Conclusion: Habitual hair pulling of childhood is a benign self limiting condition with waxing and waning course and behavioural therapy being the first line of management. Hence, adequate therapy with regular follow up is needed to prevent relapses. References 1. Bruce TO, Barwick LW, Wright HH. Diagnosis and management of trichotillomania in children and adolescents.2005;7:365-76. 2. Oranje AP, Peereboom-Wynia JD, De Raeymaecker DM. Trichotillomania in childhood. J Am Acad Dermatol1986;15 3. Lochner C, Seedat S, du Toit PL, Nel DG, Niehaus DJ, Sandler R, et al. Obsessive-compulsive disorder and trichotillomania: A phenomenological comparison. BMC Psychiatry 2005;5:2.