The trichotillomania from the Greek trichós (hair) and mania (impulse) is the medical term that describes the irresistible need they have children pulling their hair out, in any area of the body, head, eyebrows, eyelashes, for no apparent reason. Why is it produced? What are the causes? How is it diagnosed and what is its treatment? I will tell you about all this in the next article.
According to the Statistical Manual of Mental Disorders (DSM-V), trichotillomania is considered an obsessive-compulsive and related disorder, and indicates that it is characterized by repetitive and recurrent behavior consisting of hair pulling and attempts to slow or stop repeated behavior.
The trichotillomania It can occur at any age, but it occurs more in school age and adolescence, being rare, for example, in infants. Generally parents tend to associate it as a "habit", just like when they suck their thumb, until the "hairless" area that the child presents catches their attention and that is when they go to the doctor to determine what is happening.
This disorder has a variant called trichophagia, approximately 22% of those who suffer from it, which supposes that the child, after pulling it off, ingests it, forming balls of hair (trichobezoar) in the stomach that cause an obstructive syndrome whose only solution is surgical. It is characterized by abdominal and epigastric pain, nausea, vomiting, diarrhea, constipation or flatulence and, in more severe cases, it can lead to anorexia.
It is not entirely clear why does the child feel that need to pull out their hair, but what is known to date is that it could be associated with genetic factors (there are theories that support that it can be hereditary), environmental, biological (certain investigations explain that it may be due to a lack of some neurotransmitter at the brain level) and / or psychological (family tension, depression, stress).
90% of cases are associated with some external situation that is not controllable by the child. For example, separation from parents, loss of a relative, moving, starting or changing school, traumatic experiences, boredom or fatigue.
For its diagnosis, a detailed clinical history is necessary, oriented in the search for the triggering factor, as previously mentioned with respect to the causes that produce it; in turn, it is important that the doctor inquire about the presence of this disorder in the parents or siblings and other causes, whether infectious or fungal (due to fungi), must also be ruled out.
For this reason, evaluation by dermatology is recommended and the diagnosis is made based on the criteria according to the Statistical Manual of Mental Disorders DSM-V and which are the following:
- Recurrence in the behavior of pulling hair, which leads to hair loss.
- Attempts to decrease or stop the hair pulling behavior.
- Clinically significant discomfort or deterioration in social relationships with friends or family members.
- Hair loss cannot be attributed to another medical condition (for example, a dermatological condition).
- Hair loss cannot be explained by symptoms of another mental disorder.
What can parents do with children with their hair pulled out?First of all, stay calm and remember that it is not a serious illness (most cases resolve spontaneously).
It is advisable to teach the child alternative behaviors when he is nervous, for example, relaxation techniques. It is also important not to criticize, scold or punish him every time he has the urge to pull his hair, because you will only get his rejection and he does not trust you. If it does not improve, psychological support is necessary and, in extreme cases, resort to medication to treat it.
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