Habit reversal therapy - An effective treatment modality in adolescent trichotillomania: A case report

Trichotillomania is an impulse control disorder not so commonly encountered in psychiatric clinical practice. Usually patients visit to dermatologists for hair loss and subsequently being referred to psychiatrists. It is characterized by impulsive hair pulling leading to hair loss. It may follow biting the hairs and even swallowing of hairs leading to adverse sequel like trichobezoars. In the treatment of trichotillomania, selective serotonin reuptake inhibitors (SSRI), behaviour therapy and cognitive behaviour therapy are found to be effective. Among the behavioural techniques, Habit Reversal Therapy (HRT) is being proved to be highly effective. HRT is commonly tried in adult populations in comparison to paediatric population. Among the SSRIs, fluoxetine and paroxetine are commonly used. In this case report, unique combination of habit reversal therapy with Escitalopram was tried in an adolescent girl with trichotillomania which was found to be highly effective.