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Hair-pulling in the under 2s is usually a self-comfort action, often starting as twirling their hair around their fingers and only later progressing to pulling. It is often associated with thumb-sucking but can also be related to boredom: young children who pull their own hair are often very bright. At this age hair pulling is usually by twisting and is an extension of the original hair twirling action.
As babies grow into toddlers, hair pulling which started self-comfort can turn into a habit. By this age the pulling has typically changed into a direct tug. By the time they are around 3, children can tell what the adults around them are reacting to. If parents are worried or upset when their child pulls out their hair, that hair pulling can become an effective addition to the usual toddler tantrums.
It is important to distinguish between hair pulling that is a comforting habit and hair pulling that is a tantrum. If the hair pulling is a habit, ignoring it will allow the behaviour to become more entrenched, but if it is a tantrum acknowledging it can make things worse.
There is a correlation between thumb sucking and pulling hair. If your little one is a thumb sucker as well, it is usually more to work on reducing thumb sucking and hair pulling together.
If you toddler pulls out their hair during tantrums or as a conscious act of protest attempts to stop the may inadvertently alert the child to the effectiveness of this behaviour in upsetting the parent. Approach it as you would any other tantrum antics: act unimpressed and don’t change your stand, try diverting their attention elsewhere and if that doesn’t work let them go for it – toddlers may not have much sense but they aren’t stupid and won’t carry on doing something that isn’t effective for long.
When hair-pulling starts after 4, it is typically more hidden and can be a sign that something is worrying the child. It may be the early stages of trichotillomania, also known as TTM or trich, a psychological condition that involves the compulsion to pull out one’s hair. While trich typically starts at between 9 or 13, it can occur earlier, often following a period of stress or illness. If you think your child has trich, consult your GP as there are a number of treatment options.
Recent research has also shown that hair-pulling in older children and adults can be the result of irritation and itchiness from Malassezia, a naturally occurring skin and stomach yeast. Levels of this yeast can be controlled through changes in diet, but note that this research has yet to be thoroughly tested. Other research suggests that the dietary supplement N-acetylcysteine can help.