Popova Lilia, Mancuso Jennifer
University of Michigan Medical School, Ann Arbor, MI, USA.
Glob Pediatr Health. 2022 Mar 14;9:2333794X221086576. doi: 10.1177/2333794X221086576. eCollection 2022.
We present a case of a 17-year-old male with recurrent hair twirling resulting in patchy alopecia, who improved dramatically on N-acetylcysteine (NAC). Trichotillomania is characterized by repetitive hair pulling, twisting, or twirling and can vary from a mild habit to an impulse-control disorder. Standard treatment for pediatric trichotillomania includes cognitive behavioral therapy or medical therapy with selective serotonin reuptake inhibitors. NAC is a more recently utilized, safe, and well-tolerated over-the-counter supplement with some evidence of benefit for habitual skin and hair disorders. For this patient, we recommended 600 mg twice daily, increasing to 1200 mg twice daily as tolerated. After 6 months, our patient reported decreased desire to twirl his hair and his hair had almost completely regrown. Pediatricians who see patients with trichotillomania or other habitual disorders can consider treating these patients with NAC given its potential benefits and favorable side effect profile.
我们报告一例17岁男性，因反复捻发导致斑秃，服用N-乙酰半胱氨酸（NAC）后症状显著改善。拔毛癖的特征是反复拔毛、扭毛或捻发，其严重程度可从轻微习惯到冲动控制障碍不等。儿童拔毛癖的标准治疗方法包括认知行为疗法或使用选择性5-羟色胺再摄取抑制剂进行药物治疗。NAC是一种最近开始使用的、安全且耐受性良好的非处方补充剂，有证据表明其对习惯性皮肤和毛发疾病有益。对于该患者，我们建议每日两次，每次600毫克，可根据耐受情况增加至每日两次，每次1200毫克。6个月后，我们的患者报告捻发欲望降低，头发几乎完全重新长出。鉴于NAC的潜在益处和良好的副作用特征，诊治拔毛癖或其他习惯性疾病患者的儿科医生可考虑用NAC治疗这些患者。
