Hair Pulling/Skin Picking

Trichotillomania involves recurrent hair pulling, leading to noticeable hair loss and potentially causing distress or impairment in social, occupational, or other important areas of functioning. Dermatillomania, similarly, involves repetitive skin picking that can result in tissue damage, scarring, or infections. Both conditions may begin as attempts to relieve tension or anxiety but can become habitual and difficult to control.

Cognitive Behavioural Therapy (CBT), specifically Habit Reversal Training (HBT), has shown significant effectiveness in reducing or eliminating hair-pulling and skin picking behaviours in adults. Habit Reversal Training focuses on identifying the specific triggers and situations that lead to hair pulling or skin picking episodes. Through awareness training and developing competing responses, individuals can learn to interrupt the automatic nature of these behaviours and replace them with more constructive actions.

In addition to CBT, other therapeutic approaches such as acceptance and commitment therapy (ACT) and dialectical behaviour therapy (DBT) may be beneficial for individuals struggling with trichotillomania or dermatillomania. ACT focuses on increasing psychological flexibility by teaching mindfulness skills and promoting value-based behaviour change, which can help individuals tolerate distressing emotions without resorting to hair pulling or skin picking. DBT incorporates skills training in emotional regulation, distress tolerance, and interpersonal effectiveness, providing a comprehensive approach to managing symptoms and improving overall well-being.

Children may also engage in hair pulling and skin picking as coping reactions to strong emotions such as anxiety, anger, or boredom. Recognizing these behaviours early and providing appropriate support is crucial for a child’s well-being.

In children, trichotillomania and dermatillomania can manifest similarly in adults, with hair loss or skin damage being noticeable signs. These behaviours may interfere with social interactions, academic performance, and self-esteem development, requiring intervention to prevent long-term consequences.

Cognitive Behavioural Therapy (CBT), including Habit Reversal Training (HBT), is highly effective in helping children reduce or eliminate hair pulling and skin picking behaviours. By working with a therapist, children can learn to identify triggers and develop alternative coping mechanisms to replace these behaviours. Parental involvement in therapy sessions is crucial for reinforcing strategies at home and providing emotional support to children throughout their treatment journey.