Trichotillomania is considered a type of impulse control disorder in DSM-IV-TR where repetitive hair pulling results in hair loss, distress, and social and occupational dysfunction. The peak age of onset is 12-13 years. The lowest age reported is 18 months through a case report, while all other cases reportedly began around the age of 10 years. Early-onset (eg: childhood) is thought to be a benign, self-limiting habit, while later onset (eg: adolescence and adults) is associated with increased psychopathology. We are writing about a 7-year-old girl who presented to our clinic with skin-picking and hair-pulling on her eyebrows, eyelashes, and the hairs on her arms and legs. The treatment of choice for trichotillomania is HRT. There are no published studies to date revealing efficacy of treatment in childrent below the age of 8 years.
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