ABSTRACT
Hair pulling most commonly involves the scalp, with irregular patches of hair loss that often show bizarre borders. Long-term disorder may lead to scarring alopecia.
The affected areas are not completely bald, but show short broken hairs of varying lengths. Patients often deny the habit, and it may be difficult to convince the parents of affected
children of the diagnosis. Dermoscopy is very useful to show the evidence of pulling: the scalp shows short coiled
fractured hairs. The broken hair shafts often show longitudinal splitting. Trichotillomania and alopecia areata may occur together: in these cases, dermoscopy shows the features of both conditions.
