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.
Say
I love you
You are beautiful
You are important
You are worthy
Your BFRB does not define you
Do not say
Stop pulling, picking, biting
You look like you've been pulling, picking, biting a lot
Cover that spot
Do not tell other people about your child's BFRB without their permission
Do not scold, shame, or punish your child 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.
Your child's journey with BFRBs is very personal. Remember that a BFRB is a medical diagnosis that doesn't define your child. They have so many special gifts beyond their hair pulling, skin picking, nail biting, or cheek biting. Disclosing to anyone should be their decision. If they're at a place where they feel comfortable sharing their medical diagnosis with their friends - trust them, even though you may be afraid their choice to disclose may hurt them. Perhaps they've discovered that their friends have interests in common like music, movies, fashion, art, sports, or more. Trust your child to make a good decision for themselves; and be there to celebrate if things go well or with encouragement if things become challenging.
Offer to role-play with your child how they plan to tell their friends. Make gentle suggestions where needed, coming from a place of love.
Keeping the lines of communication open with your child is important for their overall physical health and emotional well-being. Learning more about BFRBs gives you the opportunity to become your child's best advocate. The TLC website is a good start, along with participating in TLC's health education and community programs.
Going to a salon can be a big emotional step for people with hair pulling. TLC offers a referral directory listing of BFRB-friendly salons. We're working every day to grow the number of salons listed with TLC, so come back regularly to check for updates near you.
Remember that it may take some time to find the right stylist for your child.
It's okay to try several before you decide on the one that works best.
If your child is struggling at school with BFRBs consider the types of interventions that work well in other environments. Engage your child in a dialogue about what they think might be helpful, then approach your child's teacher about coming up with a plan together. If your child qualifies for special education services, additional accommodations may be possible through their Individual Education Plan (IEP) or 504 Plan. Additional articles regarding school interventions can be found here.
When teachers and school staff know about your child's BFRB, it may make for an easier school year for the child, family, and school. However, disclosing your child's BFRB is a very personal decision. Start by talking with your child about their comfort level of sharing their BFRB at school. If they're new to the school, it may take time to build rapport and trust with teachers and school staff. If they're a returning student, ask them if there's a teacher or school staff member who they trust to be their safe person/advocate in case uncomfortable interactions with peers occur during the school day. If your child's BFRB is noticeable, such as bald patches, heavy scarring, etc., consider asking the teacher if additional education can be provided to classmates and their parents about body-focused repetitive behaviors to help break down myths and misperceptions and build inclusion.
Forming a strong school and home partnership sets everyone, most importantly your child, up for a successful school year.