The hair loss experienced from hair pulling can impact self-esteem and self-confidence. Many BFRB community members, especially girls and teens, share that not having hair impacts their feeling of femininity and/or belonging with peers. A wig can restore their self-confidence while also helping manage their behaviors. Although a wig may not stop their hair pulling, having a wig allows them to feel more comfortable at school and in community.
It's a big myth that parents are responsible. No, your child's BFRB is not your fault. You are not to blame for your child's BFRB. Your child's BFRB is not a reflection of you as a parent. BFRBs are caused by a multitude of things, such as temperament, environment, age of onset, etc. Even if you personally struggle with a BFRB yourself, it is still not your fault.
This is a hard question to answer. We don't know why some children are able to move on from having a BFRB and not be affected again, while others struggle. What we do know is that learning to pay attention to the needs of the body, even after the behavior has stopped, is the most effective way to manage. Some clinical evidence shows that toddlers or infants who have a BFRB (known as "baby trich") may stop the behavior as they grow and develop; however, this is not always the case. Usually, BFRBs which typically begin at the age of 12 are chronic disorders, that may wax and wane over time.
Unfortunately, there is nothing you can do to ensure this won't happen. It is not uncommon for people with BFRBs to pick/pull from other areas of their body, so don't be alarmed if your child starts to do so. It's very hard to stop pulling/picking from an area once you start, so don't expect your child to automatically stop. The best thing you can do is offer your support and unconditional love.
Do not scold your child or punish them for their BFRBs. Your child's BFRB is not something they can control, and it is not their fault. It's not your fault either. BFRBs are not self-harm. BFRBs are not caused by trauma.
It is critically important that you keep the lines of communication open with your child in order to support their overall physical health and emotional well-being. The more informed you become about BFRBs, the better advocate you can be for your child.
Research shows that some people may have an inherited predisposition to skin picking or hair pulling. Several studies have shown a higher number of BFRBs in immediate family members of persons with skin picking or hair pulling than would be expected in the general population. However, this does not mean your child will develop a BFRB; there are a number of other factors that are involved, such as temperament, environment, age of onset, and family stress factors.
Although BFRBs may, in some forms, be relatively benign, when they are done in excess they can cause serious medical problems. For the subset of individuals who swallow pulled hairs (a BFRB called trichophagia), gastrointestinal distress or even digestive blockage called a trichobezoar (or hairball) can occur, sometimes requiring surgical removal. This is a very serious medical condition that may require immediate action. It is important to see a doctor if your child eats their hair. Regarding skin picking, it is important to keep wounds clean and treat them with antibiotic cream to prevent infection. In some cases, frequently practiced BFRBs may result in repetitive motion injuries.
It is critically important that you keep the lines of communication open with your child in order to support their overall physical health and emotional well-being. The more informed you become about BFRBs, the better advocate you can be for your child.