Toddler Pulling Hair: Is It Trichotillomania?

If your toddler twists and tugs at their hair as they drift off to sleep, or you’ve found a small tuft of hair in the cot, you’re not alone and you haven’t done anything wrong. A toddler pulling hair is a well-known pattern. Children’s doctors see it often, and researchers have written about it for decades.

This guide is for parents of children under five. It covers why toddlers pull, how it differs from trichotillomania (the hair-pulling condition that usually starts later in childhood), whether children grow out of it, what helps, and when to see a doctor.

Why do toddlers pull their hair?

Most toddlers pull their hair to soothe themselves. The feel of the hair, and the steady twisting and tugging, can be calming in the same way as sucking a thumb or stroking a favourite blanket. That’s why a toddler pulling out hair when tired, bored or upset is such a common picture.

The Sydney Children’s Hospitals Network, which runs children’s hospitals in Australia, describes babies twisting or gently pulling their own hair, or a parent’s, while sucking a thumb before sleep or when distressed, and calls it normal self-soothing. Many toddlers simply carry the habit on.

A 2024 survey of parents of children aged five and under found that children who pulled also twirled their hair more, slept less well, and tended to be more sensitive to sensations around them than children who didn’t pull.

When it tends to happen	What’s usually going on
Falling asleep, nap time, waking in the night	Winding down; hair works like a comfort object
Alongside thumb or finger sucking	Two comfort habits working together
In the car seat, the pushchair, or in front of a screen	Quiet, still time with hands free
When cross or frustrated	Letting out big feelings

Around the age of three, toddlers also notice how adults react. The same guidance points out that if pulling gets a worried or upset reaction, a toddler may start using it to show frustration or get attention. That’s one reason a calm response matters so much.

Is it trichotillomania?

Usually not, at least not in the sense the word is used for older children and adults. Children’s hospital guidance says some hair pulling in babies and toddlers is part of normal development and is not usually a sign of trichotillomania.

Trichotillomania is a body-focused repetitive behaviour (BFRB), one of a group of conditions where people repeatedly pull, pick or bite at their hair, skin or nails. In older children and adults it involves strong urges, failed attempts to stop, and real distress. Pulling that starts in the first years of life is sometimes called “baby trich” to mark it out as a different pattern.

A survey of 110 parents of children aged up to 10 found that preschool children were less likely than school-age children to notice they were pulling, feel tension beforehand, or be distressed by it.

	Hair pulling in babies and toddlers	Trichotillomania in older children and teens
Usual start	In the first two or three years, often around age one	Most often between 10 and 13
Does the child notice?	Often not	Usually yes, and often hides it
Feeling beforehand	Rarely any tension or urge	Often a building urge or tension
How it tends to go	Often fades as the child grows	Tends to come and go over years without help
What helps most	Calm routines, comfort swaps, covering hands at sleep times	Talking therapy, with parents as coaches

Some very young children do have a more stubborn problem. One US clinic described toddlers whose frequent pulling caused bald patches, after their parents had been told it was harmless. So the label matters less than how much the pulling is affecting your child.

If your child is older, our guide for parents of children with trichotillomania covers school-age pulling. There’s also a section on children and teenagers in our complete guide to trichotillomania.

Will my toddler grow out of it?

Many toddlers do. Doctors have long described early childhood pulling as a short-lived habit that fades on its own, like thumb sucking, and that is still the most likely outcome.

The research behind that reassurance is thin, though. A 2012 study of 98 adults with trichotillomania noted that it rests on limited evidence, and found some adults whose pulling had started in early childhood and never stopped.

There’s encouraging evidence too. In a published case of a two-year-old who pulled at nap time and bedtime, covering the child’s hands at those times stopped the pulling completely, and the hair grew back fully. When pulling and thumb sucking happen together, clinicians report that gently easing the thumb sucking can sometimes reduce the pulling too.

In plain terms: expect it to fade, but don’t simply wait if it’s getting worse. The gentle steps below are easy, harmless, and help either way.

What should I do?

Stay calm, learn when it happens, give your child’s hands another source of comfort, and protect the times when pulling is most likely. Here’s how.

Notice when it happens. For a week, jot down when and where your child pulls and how they seem. The pattern often points straight to the answer: bedtime, the car seat, or screen time.
Offer a comfort swap before pulling starts. A soft toy with a ribbon or satin tag, a blanket with a silky edge, or, for older toddlers, a large squishy or textured toy can give the same soothing feel. Put it in their hands as they wind down, rather than only after each pull, which one clinic found can end up rewarding the pulling.
Cover little hands at sleep times. If most of your toddler’s hair pulling happens while sleeping or dropping off, loose, soft cotton mittens or gloves at nap time and bedtime make it harder. Children’s hospital guidance suggests checking with your doctor first.
Build a calm wind-down routine. Toddlers who pull often have more unsettled sleep. A predictable routine of bath, pyjamas, story and bed gives a tired child other ways to settle.
Redirect gently. If you see your child pulling, calmly move their hand and offer the comfort item, then carry on with what you were doing. Keep your voice and face relaxed.
Notice the good moments. For toddlers over about two and a half, one clinic had success with warm praise and small stickers for short stretches without pulling, slowly making the stretches longer.

A short, predictable wind-down helps many toddlers settle without reaching for their hair.

For babies under one, follow safe-sleep advice. The NHS says to keep a baby’s cot clear of soft toys, pillows and loose blankets, so save comfort toys in the cot for older toddlers. Ask your doctor or baby’s nurse if you’re unsure what’s safe for your child’s age.

Give little hands something else to hold, and soft mittens at sleep times can help too.

A shorter haircut can make hair harder to grab; discuss it with your doctor. Shaving the head isn’t a fix: in one case report, a toddler whose head was shaved started pulling other people’s hair instead.

Our guide to pulling at night has more ideas for bedtime.

What should I avoid?

Avoid anything that turns pulling into a battle or a source of shame. Toddlers can’t stop a comfort habit on command, and pressure tends to make it stronger.

Telling off, punishing or smacking hands. It adds stress, and being upset is one of the times toddlers reach for their hair.
Big reactions. A gasp or a raised voice teaches a toddler that pulling gets attention fast.
Checking their head or pointing out patches. Keep hair a neutral, everyday topic.
Holding hands down while they’re awake. Parents in published case reports found this upset their child and didn’t help.
Anything designed to sting, hurt or taste bad. Comfort habits respond to comfort, not discomfort.
Blaming yourself. Hair pulling isn’t caused by bad parenting.

When your child is old enough to talk about it, our guide to talking to your child about hair pulling has words that help.

Could it be something else?

Yes, sometimes. If you haven’t seen your child pulling, or the skin looks sore or scaly, get it checked.

	Hair pulling	Alopecia areata	Scalp ringworm
What it is	A comfort habit or, less often, trichotillomania	An immune condition that makes hair fall out	A common fungal infection
What the patch looks like	Uneven edges, hairs of different lengths, often more on one side	Smooth, often round bald patches with no broken hairs	A scaly, dry or itchy rash with patchy hair loss
What you might notice	You see your child twisting or pulling	Hair falls out without pulling	A rash, which can spread through close contact
Who helps	Your doctor, and support with the habit if needed	Your doctor, who may refer to a skin doctor	Your doctor; scalp ringworm usually needs prescription tablets and shampoo

Our guide to trichotillomania and alopecia explains the differences in more detail.

When should I see a doctor?

See a doctor whenever you’re worried, and don’t wait if any of these apply. The NHS advises seeing a GP if you notice your child pulling out their hair.

You can see bald patches or clear thinning.
Your child pulls eyelashes or eyebrows, or their eyes look red or sore.
Your child chews, eats or swallows hair (see below).
The scalp looks red, sore, scaly or broken.
Pulling is spreading to more times of day, or getting worse despite the steps above.
Your child seems upset by it, or you have other worries about their sleep, behaviour or development.

Start with your child’s paediatrician or family doctor, who can check the scalp and refer you on if needed.

The doctor will look at the hair loss, check for other causes such as a skin infection, and can refer you on if pulling isn’t easing.

Our guide on when to take your child to a doctor about hair pulling covers what to expect at the appointment.

If pulling carries on as your child gets older, you can search our directory for someone who understands hair pulling and works with children and families.

For calm, practical support at every age, The Parent’s Guide to Trichotillomania is about understanding what your child is going through.

Questions people ask

Is my toddler’s hair pulling my fault?

No. Hair pulling in toddlers isn’t caused by bad parenting, and nothing you did made it start. It’s usually a comfort habit, like thumb sucking. The way you respond now, calmly and without fuss, is the part that helps most.

Why does my toddler pull my hair when falling asleep?

Twisting or gently pulling a parent’s hair is a common way for babies and toddlers to settle, often alongside thumb or finger sucking. It’s the same comfort habit, aimed at you. A soft toy with a ribbon, or a blanket with a silky edge to hold instead, often helps.

My toddler pulls their hair during tantrums. Is that the same thing?

It’s slightly different. Some toddlers pull their hair when they’re cross or frustrated, as a way of letting feelings out. Around age three, children also notice how adults react. Keeping your response calm and low-key, and helping with the feeling rather than the hair, usually works best.

Will my toddler’s hair grow back?

For most children, yes. Hair usually fills back in over a few months once pulling eases, and regrowth can look a little different at first. In one published case, a two-year-old’s hair grew back completely after the pulling stopped. A doctor can check the scalp if you’re unsure.

Is it normal for a baby to pull their hair?

It can be. Children’s hospital guidance describes babies twisting or gently pulling their own hair, or a parent’s, while sucking a thumb or before sleep as a normal self-soothing behaviour. Mention it at your baby’s next check-up if hair is thinning or it seems to bother them.

Should I tell my toddler’s childcare setting?

It usually helps. A short, matter-of-fact note means carers can offer the same comfort item at nap time and respond calmly rather than telling your child off. They can also tell you when pulling happens there, which helps you spot patterns you might not see at home.