Alopecia areata (AA) is a common dermatological disease characterized by patchy areas of nonscarring alopecia. Trichotillomania (TT) is an expression of obsessive-compulsive disorder defined by the urge to pull out his/her hair. We describe a case of AA coexisting with TT. A 6-year-old male child presented with a localized patch of hair loss in the occipital area of 2 years duration. Dermoscopy revealed numerous exclamation mark hairs along with signs of scratching and bleeding. A detailed medical anamnesis and thorough examination of the child during the consultation put in evidence TT.