Did cutting Amy’s hair short stop her compulsive hair pulling habit?

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It is a year today since we finally bit the bullet and cut Amy’s hair super short so that she would no longer be able to twirl it into knots and pull it out. At the time her hair was really thin on the left side but I had been holding out for her hospital appointment which was scheduled for mid June thinking that it would be best for the paediatric consultant to see the full extent of the damage she had done. My Dad pointed out that pictures would probably do the trick and so with Amy enthusiastic for a her “cool, new teenager hair” and keen to donate her hair to The Little Princess Trust, we booked an appointment.

Just to give you a little background – this wasn’t the first time Amy had caused herself a near-bald patch on one side of her head. (You can read more about Amy’s compulsive habits here.) For as long as we can remember she has sucked her thumb and twirled her hair – the first time the damage was noticeable was around Easter 2016 when she was 2.5yrs old. Aunty Nic and Grandad treated her to Nellie to try and keep her hands busy and break the habitual hair twirling.

Over the coming years we tried everything we could think of – pyjamas with fold over mittens, wellie socks up to her armpits to cover her hands at night, reward charts, being cross with her – and whilst some of these solutions worked in the short term, and even let her hair start to recover, before we knew it we’d be finding knots hidden under her pillow or down the back of her bed again and the thin patch would become noticeable once more.

Eventually in March of last year, I took her to the doctor to seek help for her hair pulling. The GP was really supportive and explained Amy had Trichotillomania but that he didn’t really know what to do to help us. You can read more about our first appointment with the GP and our search to get support for hair pulling here, but eventually we were referred to Paediatrics and an appointment was made for the middle of June.

As I mentioned at the start of the post, we decided to literally cut our losses and crop Amy’s hair in the middle of May before she could make her hair any worse – I was really worried that she would cause permanent damage. As it was this turned out to be the right decision as when we got home from our holiday in France at the start of June, we were greeted by a letter explaining that her appointment had been postponed and would now be at the start of August. Another six weeks away and over four months since we first sought help.

Luckily cutting her hair short seemed to have done the trick. The shorter style had instantly made her hair look thicker and healthier and she could no longer get her fingers into it to twirl it and pull it out. Everyone loved her new short and trendy do and she even got a special mention in the school newsletter for donating her hair to charity.

In the middle of July we went on a family holiday to Portugal but when we got home there was another letter from the hospital waiting for us – this time they hadn’t just postponed her paediatric appointment – they had cancelled it altogether. I was fuming. There was no reason given in the letter and no contact details – just a message to say her appointment had been cancelled and referred back to the GP. Of course when I rang the GP they knew nothing about this – they had nothing on her records since March when we’d first attended the surgery and had had no contact with the hospital. There was nothing I could do bar go back to the GP and asked to be referred again which I didn’t rush to do as Amy’s hair seemed to be in pretty good condition and things seemed settled.

Eventually, a couple of months later we received a letter from the GP to say that the consultant had decided she didn’t need to be seen (goodness knows how they came to this conclusion having never seen her in the first place? Surely the GP referral is enough to say she did need to be seen?) and a message from the GP saying I should book her an appointment if I was worried about vitamin deficiency – which had never been the case.

At this stage I was fairly raging that we were now almost six months down the line from first seeking help from our GP and nothing had been done. We’d been written off and left to it.

By August Amy had decided she wanted to try and grow her hair again – she had a bit of a trim to tidy her hair up but we kept it longer so she could start to grow out her crop. Unfortunately, almost as soon as her hair was long enough, we started to find knots (most significantly when we were away at Darwin Forest so it was definitely new pulling and not a previous knot that had just appeared from somewhere in her bedroom!) I booked her an appointment and had her hair cut shorter than ever and we kept it that way for a good few months.

We’ve now reached the stage where Amy desperately wants to grow her hair long again – she want to be able to wear it in a ponytail, to be able to plait it and to be able to swish it around like a princess – so we’re trying again. She’s been growing her crop out since about February and whilst it looks a holy mess, she hadn’t shown any signs of twirling or pulling until just this last week or so …

I had already written this post ready to publish today, concluding that cutting Amy’s hair short was absolutely the right thing to do to break the cycle of hair pulling, and whilst she did seem to immediately replace this with a habit of picking the skin around her nails, we were finally without compulsive behaviour – even her lifelong thumb sucking habit seemed to be on the way out. But at the end of last month we realised that she had started to suck her clothes, sometimes at the neckline and sometimes the hem, and whilst this was considerably less destructive than some of her habits, it was a clear signal that she was struggling.

And then, last weekend, I found a knot in her hair. Just a small one, but a knot just the same, and when I tried to gently brush the knot out with her Tangle Teezer, her hair came out with it – it is clearly very weak as a result of the years of pulling. I’m heartbroken for her. She has obviously done it over night as was previously the case. Of course we’re not in a position to get her hair cut whilst we are in Lockdown and in all honesty I don’t want to just yet, we’ve just got past the worst of growing it out so the idea of having to cut it short again now is gutting. So, we are reverting to the old methods of putting a sock on her left hand before she goes to bed to try and prevent any twiddling / pulling.

In the last week or two we’ve been aware of Amy sucking her clothes, chewing on the back of the TV remote and twirling knots into her hair in her sleep. We absolutely knew she was struggling with Lockdown, with not being at school and with not being able to see her friends and family – this has played out through her emotional responses to things and her behaviour generally until now – you can read about how I’ve talked to Amy about her worries here – but the return to these compulsive habits is another clear signal. Were we not in the current situation with Coronavirus, I think I would be seeking additional medical advice – though based on our previous experience I’m not sure what they’d be able to offer us as it seemed she was too young to access any appropriate mental health services.

So yes, cutting Amy’s hair short was the right thing to do and yes it helped to stop the hair pulling, but it would seem it was simply a temporary pause. We treated the symptom but not the cause. Perhaps this will be a cycle we see over the years of cutting her hair short to protect it from damage and to break the habit before trying to grow it out again – who knows. I continue to hope she will outgrow this and only wish that this post had the positive conclusion I had initially written!

You can read updates on Amy’s compulsive habits and hair pulling here:

An update now Amy is 11.

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