What To Do If Your Child Starts Pulling Their Hair Out

Maybe you’re finding an abnormal amount of hair on your kid’s pillow lately, or you’ve noticed their eyelashes and eyebrows are looking sparse. That’s when you spot them at the dinner table, cramming for a quiz, pulling at their hair. If you Google anything like “child pulling hair out when stressed” or “child pulling out eyelashes,” it’s easy to see a bunch of mental health diagnoses pop up in the results and freak the f*ck out.

But don’t panic, and don’t imagine your kid has plucked themselves bald six months from now. Experts say parents often have way bigger feelings about this habit than kids, and with effective treatments available, help is out there.

Why is my child pulling their hair out?

In some cases, plucking a few hairs from their head is just another way of fidgeting the stress away. "Hair pulling can be something that people do when they're stressed, like tapping your foot or chewing on a pencil. When kids aren't pulling out enough hair that it's noticeable and it's just sort of a part of a repertoire of things they do, that's one thing," says Katie Mahon, PhD, licensed clinical psychologist for Baptist Behavioral Health.

When hair pulling becomes more noticeable or interferes with daily life, that's trichotillomania, which the Child Mind Institute describes as "a mental health disorder that causes kids to have an uncontrollable urge to pull out their hair." The pulling is a way of self-soothing, Mahon says, and is not a form of self-harm. It often begins between ages 10 and 13, and experts theorize it may have something to do with the influx of hormones in kids' bodies heading into puberty. Sometimes kids will realize they're doing it, or it may happen on autopilot when they're zoned out, like while watching TV or riding in the car, Mahon adds.

These kids may pull hair from the scalp, eyelashes, eyebrows, pubic region, or elsewhere on the body, and some will then play with or even eat the hair. This all sounds really scary, but stay with me — everything is going to be OK.

What are the symptoms of trichotillomania?

If you think your child might be pulling their hair out, the Child Mind Institute says to keep an eye out for the following:

• Uneven or one-sided hair loss
• Suddenly losing a lot of hair
• A lot of hair on the floor or pillows in the child’s room
• Constantly holding their hands near their head
• Wearing hats or other cover-ups because they don’t want others to see their bald spots
• Constantly looking in the mirror
• Low self-esteem
• Feeling ashamed about what they look like or because they can’t stop pulling out hair

Does this mean my child has other mental health conditions?

When you Google trichotillomania, you're going to see other diagnoses, like anxiety and obsessive-compulsive disorder (OCD), in the same articles. Try not to worry about whether your kid will get either of these diagnoses (or any others). It's possible, but not as likely as you may think.

"More than half the time, someone who has hair pulling won't meet diagnostic criteria for anything else. Actually, the most common thing is that you would just have hair pulling," Mahon says. "If they're going to have another thing, it would probably be something in the OCD or anxiety spectrum, but most kids who pull their hair don't have an anxiety disorder."

What should you do if your child is pulling their hair out?

If you notice these signs in your child, or you see the pulling happening, Mahon says the first step is to check your own emotions about it. "It is really distressing for parents to see. It's hard to watch and a lot of parents will feel really scared, and that can come out as frustration. You might need to step into the bathroom and take some deep breaths so you can not bring that emotionality to it, because your kid is already having feelings about it," Mahon says.

You should schedule an appointment with a mental health professional, ideally one who specializes in body-focused repetitive behaviors (BFRBs). BFRB.org has a Find A Provider directory of specialists on their website to help you find one near you, and you can filter for those who offer telehealth in your state. Cognitive behavioral therapy is an effective treatment for most kids and helps them find other ways to self-soothe, Mahon says. There are also medications that can help those who need additional support.

While you wait for your first appointment, work with your child to figure out when they're pulling and what triggers the behavior. If you see them doing it, don't admonish them; just offer a different fidget toy, Mahon suggests. If they tend to pull their hair on autopilot, maybe they start wearing a beanie when they watch TV.

Remember that this is not a behavioral issue. Mahon says there's no fixing it by saying just the right thing or offering a perfect reward and punishment system: "It's not disobedience. It's not the same as them breaking a rule or disrespecting you. It's really important for parents to take it out of that spectrum. You have to teach your kids to say please and thank you. You have to teach your kids to be kind. You do not have to teach your kid how not to pull their hair, and you actually can't. Take it off your plate, and it will be better for everybody."

Mahon says she frequently sees parents of children who pull their hair for sessions to help them cope with their feelings and fears about it. "As parents, we can get ahead of ourselves like, oh my gosh, they're going to be bald. Kids are going to make fun of them. Kids know not to pull around other kids; they don't pull in school. Even if they are, we don't see a lot of bullying around the behavior of hair-pulling. I do think that's something more of a parental fear than something that's actually happening."

So, don't hesitate to seek out help for your child and yourself. And remember, it's not your fault or your child's that hair pulling is a thing for them. It just is, and it can get better. "We all have these grooming programs deep in our brains, like how we see chimpanzees grooming each other. With something like hair pulling or skin picking, it's like you just get stuck in a loop of it. Nobody asks to have hair pulling be an issue for them. It's not caused by anything anyone said or did or didn't do."