Trichotillomania
For patients seen in dermatology clinics, good results can be obtained by confronting both the patient and the parents with the diagnosis. Supportive care by the dermatologist may be sufficient.
Shaving or clipping hairs close to the scalp may be helpful to stop the behavior and to assure the parents of the nature of the Alopecia. Shaving a circumscribed area on a weekly basis (the “hair growth window”) can have the same diagnostic and reassuring benefits. It should be remembered that the shaved (clipped) hairs are not all in the actively growing anagen stage, and several weeks may be required before total regrowth is noted. In adult groups, the treatment is difficult and disappointing and is performed best in psychiatric clinics.
It is unclear how well antidepressants and tranquilizers work for Trichotillomania Well-documented reports in the psychiatric literature show that clomipramine causes short-term improvement in adult patients who are severely affected with Trichotillomania and whose disease interferes with their daily life.
In very young children, the prognosis is excellent. In late childhood and adolescence, the prognosis is usually good but is more guarded than in young children. The Alopecia. quite often recurs after a variable time. In adult patients, the prognosis is poor, and permanent recovery is uncommon.
