July 10, 2020

Pranav Harish

What is Trichotillomania: The Hair Pulling Disorder?

You have an irresistible urge to pull out hair. It calms you down and eases your stress. You know it is wrong, but you like it.

People with trichotillomania will pull out hair from their scalp, eyebrows, eyelashes, beard, mustache, and pubic hair.

They know they can cause damage to themselves by acting on their impulses. But, they cannot stop because the act of hair-pulling alleviates their stress and anxiety levels.

Trichotillomania causes and symptoms

Trichotillomania is classified as an impulse control disorder. But, there may be a correlation between trichotillomania and OCD. Hair-pulling behavior is undesirable and may be done to cope with stress and other extreme emotions.

People display hair-pulling behavior with little or no consideration of the consequences.

One of the reasons for its cause is the chemical imbalance or impairment in particular areas of the brain that are responsible for emotions, habit formation, and impulse control.

A person with a genetic history of trichotillomania is more susceptible to being diagnosed with the same.

"Trichotillomania" may suggest some form of psychosis. That's why the term "hair-pulling disorder" is widely used to address this condition in people due to the comorbidity with OCD.

Symptoms of trichotillomania are as follows:

  1. Repeated hair pulling
  2. Increased tension or stress before hair-pulling or when trying to resist hair pulling
  3. Hair pulling gives a sense of relief
  4. Twirling and playing with pulled hair
  5. Chewing or eating pulled hair (trichophagia)

Hair pulling behavior is of two kinds:

  1. Focused - You pull your hair intentionally and are aware of this behavior. You do so to relieve tension or stress. You may also develop rituals such as finding the correct hair to pull and chewing hair.
  2. Automatic - You may pull your hair while reading or watching TV without realizing it.

Trichotillomania diagnosis

Trichotillomania usually begins in late childhood/early puberty and occurs both in boys and girls. But by adulthood, it affects more women than men.

The diagnostic criteria for trichotillomania are as follows:

  1. Repeated hair pulling leading to hair loss
  2. Repeated attempts to stop the behavior
  3. The hair pulling causes distress in social, occupational, and other functioning areas of importance
  4. The hair pulling or hair loss is not due to another medical condition
  5. The hair-pulling behavior is not because of another mental or psychiatric condition

How does trichotillomania affect you?

The complications of the hair-pulling disorder may include:

  1. Emotional distress, feelings of shame, anxiety, and depression
  2. Repeated hair pulling may lead to bald patches, scarring, infections, and affect hair growth.
  3. Hair loss can cause a person to avoid social contacts due to embarrassment.
  4. Eating the pulled hair may lead to the formation of hairballs in the stomach that can cause weight loss, vomiting, or even death.


You may dismiss the hair-pulling behavior thinking it's just a habit, or be reluctant to seek help. But, doctors will prescribe treatment and medicines depending on the seriousness of the symptoms.

The most preferred trichotillomania therapy is habit reversal therapy (HRT). It makes you aware of the symptoms and triggers. You should replace the hair-pulling behavior with another behavior, find ways to prevent hair pulling, and practice the same in different situations.

Cognitive behavioral therapy (CBT) will help you change the hair-pulling behavior and provide alternative coping strategies.

While some people with trichotillomania learn to manage the symptoms and triggers without any treatment, others might need a more intensive approach. But, if you find yourself or your loved ones with trichotillomania, then seek help immediately.

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