Trichotillomania or Hair-Pulling Disorder: Symptoms and Causes

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Do you find it difficult to stop pulling out your own hair even after noticing hair loss? This could be due to trichotillomania or hair-pulling disorder.

You might think that pulling your own hair is a bad habit, but did you know that it’s actually a disorder? People with hair-pulling disorder or trichotillomania have a strong urge to pull out their hair. They feel increasing tension until they pull out a few strands or a section of hair and feel relief after doing so. It can be in response to a stressful situation or done without much thought. They pull out hair not only from their scalp, but also from other areas such as their eyebrows and eyelashes. Read on to learn about trichotillomania and ways to stop pulling your hair out.

What is hair pulling disorder?

Hair pulling disorder, also known as trichotillomania, is a chronic disorder, says psychiatrist Dr Neetu Narang. It is characterized by repeated pulling out of one’s own hair and in most cases goes undetected until significant hair loss is seen. According to a study published in , the lifetime prevalence of this disorder, which usually begins in adolescence, is as high as 3.5 percent. Stat pearls In 2023

A woman with a hair pulling disorder
There is usually satisfaction after hair removal. Image courtesy: Freepik

It is considered a variant of obsessive compulsive disorder in which a person has uncontrollable thoughts and engages in repetitive behavior. The heightened tension before the act of hair-pulling can lead to behavior followed by a moment of relief or satisfaction, the expert said. There are two types of hair pulling:

  • Focused pulling: In this, a person deliberately acts to control unpleasant personal experiences.
  • Automatic Dragging: It happens without the person’s knowledge. This happens during sedentary activities like sitting a lot.

Once you stop pulling your hair out, new hair growth begins. But hair can take months or years to grow back.

What are the causes of trichotillomania?

It is not known what causes a person to develop hair pulling disorder, but some may do it to relieve stress. A person who has a mother or father or a sibling with the disorder is more likely to develop the condition.

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What are the symptoms of trichotillomania?

People suffering from trichotillomania experience an irresistible urge to pull out their hair.

  • They also experience increasing tension before engaging in this behavior.
  • They get tension release or satisfaction by pulling their hair out.
  • After noticing significant hair loss, they repeatedly try to reduce or stop hair pulling, but they fail to do so.
  • Skin irritation in the affected areas
  • Bald patches due to pulling one’s own hair.

How is hair pulling disorder diagnosed?

To diagnose trichotillomania, a doctor will check for hair loss. If there is hair loss, the doctor can talk about it and your behavior is related to it.

How to prevent trichotillomania?

Dr Narang says the key to preventing hair-pulling disorder is early detection of a person’s poor stress tolerance and coping skills. Stress management and early intervention to manage emotional pain go a long way in preventing hair pulling disorder.

A woman with a hair pulling disorder
Habit reversal training can help people with trichotillomania. Image courtesy: Adobe Stock

What are the ways to treat trichotillomania?

Hair-pulling disorder, like obsessive compulsive disorder, responds to anti-obsessional and anti-depressant medications, with regular follow-ups and supervision by a psychiatrist, the expert said.

There are no drugs specifically approved by the US Food and Drug Administration to treat it, but habit reversal training can help. According to the UK, the goal of therapy is to help you replace a bad habit with something that doesn’t harm you National Health Servicewhich usually includes:

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  • Keeping a diary of your habit of pulling your own hair
  • Finding triggers for hair pulling
  • Whenever there is an urge to pull hair, replace it with another action such as squeezing a pressure ball.
  • Emotional support comes from loved ones.

Trichotillomania or hair-pulling disorder usually begins in adolescence. Habit reversal training and support from loved ones can help people with trichotillomania.

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