Springdale Mason Pediatrics

Hair Loss - From Hair Twisting Habit


  • A nervous habit of twisting or pulling out the hair
  • The medical name for this is trichotillomania

Call or Return If

  • It lasts more than 6 months
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic


  • Frequent twisting of the hair
  • Broken hairs of different lengths
  • The missing hair occurs in patches of different shapes. This creates bald spots.
  • Often occurs on the side of the head. In right handed children, the hair loss is usually on the right side.
  • Rarely, it can include plucking of the eyebrows or eyelashes.
  • Can occur with nail biting, lip biting or sucking, and sore picking habits.


  • In young children, it's simply a habit to comfort one's self.
  • In older children, it may be more of a habit to relieve tension.
  • Often occurs when the child is thinking about something else.
  • Teens with hair pulling may have OCD.

After Care Advice

  • Twisting the hair feels good to your child.
  • They often don't know they are doing it.
  • Most young children outgrow it on their own.
  • Here is some care advice that should help.
Distract Your Child:
  • Often children twist their hair when they are bored or daydreaming.
  • When you see your child doing this, try to distract them.
  • Suggest they do something that will be fun
  • That will usually stop the hair pulling for now.
Treatment for Younger Children:
  • If your child is in a stubborn phase, do not comment on hair twisting. Reason: It may cause them to do it more rather than less.
  • This is how normal children react when they are 2 and 3. They are expressing their independence.
  • You don't want stopping the hair twisting to become a control battle. Reason: You will always lose because it's a rule you can't enforce.
  • Caution: Never punish your child for hair pulling.
Treatment for Older Children:
  • This advice is for school age children
  • Offer them a substitute or competing habit.
  • An example is playing finger games. Pulling at a wool pad or squeezing an exercise ball are other options.
  • Caution: Never punish your child for hair pulling.
Remove Triggers:
  • Whenever your child has a flurry of hair twisting, try to find the cause.
  • Then try to remove or reduce that trigger.
  • Also, try to lessen any pressure your child may be under at that time.
  • Reason: Playing with the hair is used to reduce stress.
  • Help your child relax in general.
  • Make sure your child has free time and fun time each day.
  • If your child has too many activities, try to lighten the schedule.
What to Expect:
  • Young children (age 4 to 10) with hair pulling usually get over it within 3 to 6 months.
  • Teens with hair pulling may need referral to a mental health expert for counseling.
  • Website for parents: www.trich.org

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
Article 2720