trichotillomania (hair-pulling) in a 4.5-year-old girl

Introduction: trichotillomania (ttm) is a type of chronicimpulse control disorder characterized by the recurrent pulling of hair, which can cause pleasure, relief of pressure and can be associated with infections or skin diseases in the hair pulling areas. case presentation: a 4.5-year-old girl without any psychiatric disorders in the family. she was cared for by her mother, and the child had a history of separation anxiety. after detection of trichotillomania, her head was shaved by her parents in order to avoid pulling of the hair, but triggered additional psychiatric problems and isolation. trichotillomania usually can be seen in children aged 10 to 13 years but in this case occurred at the young age of 4.5 years. conclusions: trichotillomania may also be seen in preschool-aged children and may be associated with separation anxiety disorder. improper and late treatment can be associated with a worsening of the disorder.