Optimizing treatment of compulsive hair pulling in children and young people: A case series from a pediatric psychodermatology service

This case series from a pediatric psychodermatology service at Guy’s and St. Thomas’ NHS Foundation Trust in London examines the treatment of compulsive hair pulling in children and young people. The study involved 11 patients, predominantly female, with an average age of 11.1 years. The service utilized a hybrid model of care combining face-to-face and virtual sessions, which was particularly effective during COVID-19. The treatment approach was based on cognitive behavioral therapy, including family therapy and acceptance commitment therapy, tailored to individual needs. Results showed that 45.4% of patients achieved complete resolution of hair pulling, while 36.4% had a substantial reduction. The study highlights the importance of a multidisciplinary approach and the potential benefits of virtual sessions in providing a safe space for patients to discuss sensitive issues, such as gender and sexuality, which were disclosed more readily in virtual settings. Additionally, the study emphasizes the need for thorough examination and psychosocial history to address dual diagnoses, such as alopecia areata.