Trichotillomania & Teenagers

Trichotillomania and Your Teen

Trichotillomania (trick-o-til-o-MAY-nee-ah), sometimes called TTM or “trich”, is a disorder that results in individuals pulling out hair strands in various parts of their body. TTM is one of several behaviors that are identified as “body-focused repetitive behaviors” (BFRB). Other behaviors in this category include skin picking, scraping of skin, or biting of nails. According to the Trichotillomania Learning Center, “trich” impacts people of all ages, with one in 50 people experiencing “trich” in their lifetime. The majority of people begin pulling out their hair between the ages of 11 and 13. If hair pulling goes unnoticed by parents, children could move into adolescence with the compulsion. If you suspect that your child is struggling with trichotillomania, it’s important to take steps to help your child.

Signs and Symptoms

There are a few common signs that your child may be engaging in BFRBs, particularly trich. Your child may engage in hair pulling in front of you. Often, individuals are compelled to pull their hair during sedentary activities, such as watching television, surfing the web, or listening to a lecture. You may also notice thinning hair or bald patches on your child’s body, perhaps on the scalp, eyelashes, or eyebrows. A very common symptom of people struggling with “trich” is social isolation and withdrawal. Pullers will likely feel embarrassed and ashamed by their behavior, which causes them to isolate from people who love and care about them.


TTM is a very real psychological and medical condition that requires treatment. The desire to pull out the hair is compulsive and may result in bald patches. Hair pulling varies based on the individual’s compulsion. Individuals may feel compelled only to pluck hair from a particular part of their head or eyebrows. Others may pluck hair from all regions of their body, unconcerned with the location. Teens are a particularly challenging TTM population because there are many other stressors in a teen’s life. Therapy for “trich” will address the hair pulling compulsion while discussing broader aspects of the child’s life.

The therapist, child, and parents determine parental involvement in therapy meetings. Depending on the age of the child and the presenting problems, the level of parental involvement will vary. Parents may be involved to a greater degree in some aspects of the therapy than in others. Living with a child who has TTM can be emotionally trying for parents as well as siblings. In addition to the individual therapy that your child receives, attending your own individual sessions may also be important.

If you notice that your child is engaging in hair pulling, you should make an appointment with your child’s pediatrician and a trained therapist immediately. Working to stop TTM requires a team approach that includes trained professionals. Supporting your child through this difficult situation is complex. Work with other adults that your child trusts to build a support team around him/her. Providing your child with resources and someone with whom to talk is a necessary first step.