What is Trichotillomania?

health wellness

Trichotillomania is a rare impulse control disorder in which the sufferer compulsively pulls out his or her own hair. People with trichotillomania most commonly pull hair from their scalp, eyelashes, eyebrows, or pubic area. While most people with trichotillomania pluck each hair out at the roots, others may pull out large handfuls at a time.

Trichotillomania usually begins in childhood or adolescence, frequently coinciding with the onset of puberty. While some children develop hair-pulling habits that subside with age, other individuals continue the behavior throughout adulthood. It is estimated that between one and three percent of Americans suffer from trichotillomania. Of those individuals, approximately 80% are women.

The direct causes of trichotillomania are unknown; however, many people with the condition also experience similar impulse control disorders, such as skin-picking and nail-biting. In many cases, the individuals suffer from depressive disorder or obsessive-compulsive disorder as well. Some evidence suggests that trichotillomania may be genetic or the result of a chemical imbalance. Stress is also believed to play a large role, as periods of high stress have been known to heighten the condition.

People with trichotillomania are often embarrassed or ashamed about their behavior, leading them to hide it from others. Because of this, low self-esteem is very common among sufferers. Furthermore, the compulsive removal of hair can lead to bald patches on the scalp or eyebrows, which contribute to the sufferer's embarrassment and depression.

In some cases, trichotillomania is accompanied by trichophagia, or the swallowing of extracted hair. This can result in the formation of a gastric bezoar, also known as a hairball. Gastric bezoars are extremely dangerous and may require surgical removal to prevent intestinal blockage.

Because trichotillomania is a behavioral disorder, treatment is usually psychological. The most successful form of treatment, known as Habit Reversal Training (HRT), focuses on increasing the patients' awareness of when and why they pull their hair out. Psychologists then aim to train patients to redirect the impulse. In some cases, antidepressants are also effective in treating trichotillomania.

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8
Trichotillomania is not 'rare'. This article starts by saying that it is rare, but then goes on to state that between one and three percent of Americans are thought to have it. That is not rare at all. it is very common and the more people that are aware of trich the better in my opinion.
- anon42632
7
I have been doing this since 1970. I do not swallow the hair by any means. But I do bite the clear end where the mitochondirial DNA is found and spit that out.

- anon37620
6
I have suffered from this from puberty. I just turned 60 and still have it to a lesser degree. Back in the 60's when it first started my family tormented and mocked me. I'm glad to see I'm not the only one.
- anon37590
5
I have a daughter in law who has this - has had it for years. She used to have beautiful hair; now she wears scarves on her head and looks like a chemotherapy patient. THanks for the information; I didn't know what this is called.
- anon37527
4
Why do doctors assume that it is psychological? It could also be physical...
- anon37499
3
I'm really glad to see this disorder is finally entering the zeitgeist. The more attention it receives, the more funding may eventually be available to find a cure. It's devastating condition for sufferers and their families.
- anon37476
1
Even though this disorder was known to exist even in ancient Greece, it was largely an obscure disorder. Trichotillomania did not become a "disorder" until 1980's. I hope some day soon, we will find out what is the cause of it and how to treat it.
- ivanka

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Written by Sally Foster
Last Modified: 22 August 2009

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