Trichotillomania in Children

Always on the Lookout

"Trichotillomania" refers to a form of hair loss where an individual pulls their own hair. It can sometimes be simply a habit - especially in very young children. In adolescents, the diagnosis of trichotillomania may signify underlying psychological illness including depression, anxiety, and eating disorders.

Trichotillomania, alopecia areata and tinea capitis are the three most common diagnoses in children followed by telogen effluvium and androgenetic alopecia. One must always at least consider this diagnosis as it is easy to miss. The presence of broken hairs, black dots, hairs of different length, and other trichoscopic features a v-sign, tulip hairs, and exclamation hairs are helpful in arriving at the diagnosis. The picture shows numerous scattered broken hairs (see green dots) in a young child with trichotillomania.