Trichotillomania is a habit of hair plucking. Classified under traumatic alopecia, its dig-nostic features include the presence of coarse areas of hair loss over the frontal/temporo-parietal region with a stubble uniformly 2.5-3 mm long and deliberate or unconscious efforts of the patient to pluck the hair. Trichotillo-mania is a habit and impulsive disorder under International Classification of Diseases (ICD-10 criteria 63.3). Trichotillomania in a child older than 8 years of age has high association with emotional, obsessive compulsive and anxiety states.

In this disorder, children pluck the hair in private and often swallow the evidence. In toddlers with this habit disorder, spontaneous improvement occurs. But in older children trichotillomania requires evaluation and therapy as in adults. Trichotillomania at times is an indication of underlying personality disorder in adults. Fluoxetine and clomipra-mine have been tried in adults, but in children benefits from such therapy have not been studied.

Fig. 1. Patches of loss of hair involving frontal and temporal regions of the scalp.

P.S. Ragavan,
S. Mahadevan,
Department of Pediatrics,
Jawaharlal Institute of Post Graduate Medical Education and Research,
Pondicherry 605 006, Tamilnadu, India