In this mental health condition, people can't resist urges to pull out hair from their body. They do this often. Therapy may help reduce or stop urges.
Update Date: 22.11.2023
Trichotillomania (trik-o-til-o-MAY-nee-uh), also called hair-pulling disorder, is a mental health condition. It involves frequent, repeated and irresistible urges to pull out hair from your scalp, eyebrows or other areas of your body. You may try to resist the urges, but you can't stop. Trichotillomania is part of a group of conditions known as body-focused repetitive behaviors.
Pulling out hair from the scalp often leaves patchy bald spots. This can cause a lot of distress and can affect your work, school and social life. You may go to great lengths to hide the hair loss.
For some people, trichotillomania may be mild and can be managed. For others, the automatic or deliberate urge to pull out hair is too much to handle emotionally. Some treatment options may help reduce hair pulling or stop it entirely.
Symptoms of trichotillomania often include:
Often trichotillomania also includes picking your skin, biting your nails or chewing your lips. Sometimes pulling out hairs from pets or dolls or from materials, such as clothes or blankets, may be a sign. Pulling out hair is usually done in private. An episode can last from a few seconds to hours. You may try to hide your condition from others.
With trichotillomania, pulling out hair can be:
You may do both automatic and focused hair pulling, depending on the situation and your mood. Certain positions or activities may trigger pulling out hair, such as resting your head on your hand or brushing your hair.
Trichotillomania can be related to emotions, including:
Trichotillomania is a long-term disorder. If not treated, symptoms may come and go for weeks, months or years at a time. Also, symptoms can vary in severity over time. For example, hormone changes during the menstrual period can worsen symptoms in some females. Rarely, pulling out hair ends within a few years of starting.
If you can't stop pulling out your hair or you feel embarrassed or ashamed by your appearance as a result, talk to your health care provider. Trichotillomania is not just a bad habit, it's a mental health condition. It's not likely to get better without treatment.
The cause of trichotillomania is not clear. But like many complex disorders, trichotillomania likely results from a combination of genetic and learned factors.
These factors tend to increase the risk of trichotillomania:
Although far more women than men are treated for trichotillomania, this may be because women are more likely to seek medical advice. In early childhood, trichotillomania occurs just as often in boys and girls.
Although it may not seem serious, trichotillomania can have harmful effects on your life. Complications may include:
To diagnose trichotillomania, you'll likely start by having a physical exam. You may then be referred to a mental health professional with experience in treating trichotillomania. Diagnosing trichotillomania may include:
Some treatment options have helped many people reduce hair pulling or stop completely. These include therapy and sometimes medicine.
Types of therapy that may be helpful for trichotillomania include:
Therapies that help with other mental health conditions that often occur along with trichotillomania, such as depression, anxiety, or problems with alcohol or drug use, can be an important part of treatment.
Although no medicines are approved by the U.S. Food and Drug Administration specifically for the treatment of trichotillomania, some medicines may help control certain symptoms, such as anxiety and depression.
For example, your health care provider may recommend an antidepressant, such as clomipramine (Anafranil). Research suggests that N-acetylcysteine (as-uh-tul-SIS-tee-een), an amino acid that affects mood, also may help. Another option that research suggests may have benefit is olanzapine (Zyprexa). This drug is used to treat certain serious mental health conditions that affect the mind.
Talk with your health care provider about any medicine recommended. The possible benefits of medicines should be balanced against possible side effects.
You may find dealing with trichotillomania challenging. It may help to join a support group for people with trichotillomania so that you can meet others with similar experiences who can relate to your feelings and offer support. Having a family member or loved one join you to learn how to respond to your hair pulling also can be helpful.
Ask your health care provider or mental health professional for a suggestion. The TLC Foundation for Body-Focused Repetitive Behaviors is an excellent resource for education, support and treatment options for trichotillomania.
Seeking help is the first step in treating trichotillomania. At first you may see your primary care provider or a specialist in skin disorders called a dermatologist. Your provider may refer you to a mental health professional with experience in diagnosing and treating trichotillomania.
Before your appointment make a list of:
Questions to ask include:
Don't hesitate to ask other questions during your appointment.
You'll likely be asked a number of questions, such as:
Be ready to answer questions so that you'll have time to talk about what's most important to you.
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