Dr John Irvine 20/02/08
Hairy Problems
?Bad hair day? doesn?t only apply to mothers! Sometimes this may take the form of hair-pulling problems (Trichotillomania) or hair-loss problems (Alopecia) but more commonly it?s your everyday hair-battle problems.
Here?s how one mum put her pain -
Dear Dr John
What do you do when a minor confrontation with your child blows up in your face? Recently my five-year-old daughter asked me to brush her hair. Usually this is a ritual that we both enjoy but this particular day had been windy and her hair was knottier than usual. Of course the hair and brush wouldn?t co-operate ? neither would my daughter and we both ended up more than a little frustrated. Unfortunately, the scene escalated almost beyond control as my daughter worked herself up, crying and screaming, to the point she was physically sick. By
this time I was yelling at her too, and in one part of my mind couldn't believe that it was even happening. What?s your advice so this doesn?t happen again?
So let?s tackle this issue first:
? If this was a regular occurrence then the first thing to change could be the time, place, pace, pressure in the air around hair doing.
? The second thing to consider is the hair style. If the kids aren?t looking after it, or it?s knotty, maybe talk to the hair dresser who may be able to ?sell? the kids a new ?cool? look that is much shorter and less trouble. Maybe for those who want it long for ballet etc, a plait or braid may be the go.
? However it?s amazing how a bit of reverse psychology can work sometimes. Instead of her knots getting mum in knots over something not worth the friction, maybe let them go to school with knotted or undone hair, maybe tied back in a pony tail and then sorting it out at bath time when everyone?s less frantic. Alternately give the school a call and ask the teacher to notice the mop and ask that she (sorry but I?ve had three daughters with this issue!) have it done tidier the next day ? marvellous how an outsider can achieve things that poor parents
can?t.
? Some mums tell me that another way to tackle it is with a wide tooth comb or better still a detangling comb (Avon make a good one but also available at pharmacies or hair accessory shops) and then starting from the tips, gently and gradually work out tangles bit by bit. It might help to spray with water with a bit of conditioner added.
Now let me tackle the increasing incidence of trichotillomania, hair-pulling problems. Trichotillomania involves the repetitive, uncontrollable pulling of one?s body hair. Most commonly, scalp hair, eyelashes, and eyebrows are pulled, although hair may be pulled from any location. Sometimes it will be noticeable on the pillow but more often noticed when washing the kids? hair. It?s natural to assume that anxiety is a cause and in fact trichotillomania is often cast as an Obsessive Compulsive Disorder but genes can play a part apparently as can hair texture (eg annoying coarse hairs) or mood, or anxiety or preoccupation or situation or as a way of getting back at people (eg parents) that have asked kids not to pull hair (i.e. it?s a form of guerrilla warfare).
Obviously where anxiety, revenge or attention are involved, psychological help is needed. With little kids I often just try to distract them or get them to wear gloves at bed time or sometimes have used beanies or some other head gear to remind them. Sometimes with older kids it?s a matter of making them aware of the habit and finding alternate actions or challenging anxiety provoking thoughts and teaching relaxation. With some kids and adults sometimes medications such as Anafranil or another tri-cyclic anti-depressant may be incorporated into the treatment plan. Alopecia is another story. It?s not intentional or deliberate and is more often related to some medical condition such as iron deficiency or
chemotherapy.
I must share one little story. Just before last Christmas Kent?s mum brought him in with hair missing from above his right ear. He would put his left hand over his head when he was tired and just tug away. We gradually got on top of it, but being Christmas and grandma being a great knitter, I asked her to make a Christmas beanie with little Christmas symbols knitted into it. I convinced Kent that he had to wear it at night so Santa and reindeers would know where to bring presents. He thought this was great and out he went happy to attract Santa and, in so doing, we were hopeful it would control his hair-pulling urge. However, mum phoned in later to say that she was in hysterics, when, on the way home from the clinic, the little fella had asked her why Santa couldn?t tell where to bring the toys from all the Christmas lights they had out the front. She said that she muttered about the beanie being more personal and just for him. Kent looked puzzled but it worked.
Dr John Irvine
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