Trichotillomania: Understanding the Hair-Pulling Disorder

Trichotillomania is a behavioral disorder that involves recurrent, irresistible urges to pull out one’s own hair. This hair-pulling can occur from any part of the body, including the scalp, eyebrows, lashes, pubic area, and beard, and can cause significant distress and impairment in daily functioning.

Trichotillomania is classified as a type of obsessive-compulsive and related disorder and is estimated to affect up to 4 in 100 people. It is more common in females and typically begins in childhood or adolescence.

The exact cause is not known, but it is thought to involve a combination of genetic, neurological, and environmental factors. People with this compulsion often experience feelings of tension or anxiety before pulling out their hair and a sense of relief or pleasure after doing so.

Diagnosis of trichotillomania is made based on the presence of recurrent hair-pulling and the resulting hair loss, as well as the impact of the behavior on daily functioning. It is important to seek professional help for trichotillomania, as the hair-pulling can lead to physical and emotional distress, and may result in secondary complications such as skin infections and scarring.


Treatment for trichotillomania typically involves a combination of therapy and medication. The goal of treatment is to reduce hair-pulling and improve quality of life.

Cognitive Behavioral Therapy (CBT): CBT is a commonly used form of therapy that can help individuals with trichotillomania to understand and change the thought patterns and behaviors that contribute to their hair-pulling. In CBT, individuals work with a therapist to identify and challenge negative thoughts and beliefs related to hair-pulling, and learn new coping strategies to manage urges to pull.

Medication: Certain medications, such as selective serotonin reuptake inhibitors (SSRIs), may also be used to manage symptoms of anxiety and depression that are often associated with trichotillomania. While medication alone is not usually enough to treat trichotillomania, it can be an effective adjunctive therapy in conjunction with CBT.

Habit Reversal Training (HRT): HRT is a behavioral therapy that can help individuals with trichotillomania to recognize and control their hair-pulling behavior. In HRT, individuals are trained to become aware of the physical sensations and environmental cues that precede hair-pulling, and to substitute another behavior in its place.

Family Therapy: Family therapy can be helpful for individuals with trichotillomania, particularly for children and adolescents, as it can provide support and education for families to better understand and manage the condition.

Support Groups: Joining a support group for individuals with trichotillomania can provide a sense of community and can be a valuable source of information and encouragement.

It is important to note that what works for one individual with trichotillomania may not work for another. The best course of treatment will depend on the individual and the severity of their symptoms, and may require some trial and error to determine what works best. It is also important to work with a mental health professional who has experience treating trichotillomania.

Living with trichotillomania can be challenging, but with proper treatment and support, it is possible to reduce hair-pulling and improve quality of life. If you or someone you know is struggling with trichotillomania, it is important to seek help from a mental health professional.

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