Trichotillomania, better known as hair-pulling disorder, causes a person to pull and twist at his or her own hair obsessively, resulting in hair loss and bald patches. This not only includes the hair on one's head, but also eyebrows, eyelashes, facial hair, nose hair and pubic hair. The Diagnostic and Statistical Manual of Mental Disorders currently has trichotillomania classified as an impulse-control disorder, but there is some question by professionals as to whether or not this may be an addiction, a tic disorder or related in some way to obsessive compulsive disorder.


Symptoms of Trichotillomania


Symptoms of trichotillomania are generally able to be seen by observation, unless the patient has a habit of covering up the hair damage done by the disorder. Large patches of baldness may form an unusual shape, or hair can be of varying lengths due to breakage and follicle damage. Following is a brief list of signs and symptoms that may indicate this disorder:

  • hair-pulling that results in sparse, patchy or bald spots on the head, eyebrows or other parts of the body
  • rubbing pulled out hair across the face, lips or between the fingers for the purpose of pleasurable sensation
  • chewing or eating the hair
  • hiding hair damage with wigs, hats, scarfs, makeup or other fashion accessories
  • ritualistic actions during the intentional behavior
  • unconscious hair pulling


Causes of Trichotillomania


The exact cause of trichotillomania is a mystery, and because there is some question regarding classification of the illness, evidence from research studies varies. Genetic susceptibility may play a role, as can brain chemical imbalance or mild damage to portions of the brain. Severe anxiety, stress and family dysfunction may trigger this type of response in some people. This disorder usually develops in adolescence and does appear to run in families. Some studies indicate that people develop this disorder to compensate for negative emotions or because certain hair on their bodies becomes bothersome. Trichotillomania may begin by habit, eventually leading to diagnosis.


Diagnosing Trichotillomania


Seeking diagnosis for trichotillomania is especially important to because of the possible complications. In addition to the potential for permanent hair loss, one may develop carpal tunnel syndrome from constant wrist motion during hair-pulling. People who eat the hair they pull out are at risk of developing a hair ball, which can be fatal. Physical symptoms of this disorder may also lead to added emotional distress and self-imposed lifestyle restrictions, such as avoidance of public places or forming intimate relationships. A psychiatrist or psychologist can perform an evaluation by asking specific questions, observing physical symptoms and evaluating behavior and responses to questions and proposed hypothetical scenarios.


Treatment Options for Trichotillomania


Treatment options for trichotillomania vary according to individual, usually by age. Since the majority of patients are children and adolescents, medication options are generally avoided. Young children frequently outgrow the behavior and in these cases, it's recommended to ignore the situation until it becomes a problem. Teenagers and adults may find the best results from engaging in one or more forms of therapy. Following is a brief list of therapy options that may be of benefit:

  • Habit Reversal Training – this type of therapy teaches the patient to recognize the feelings of impulse and redirect that impulse into a more positive and productive action. This and other types of cognitive-behavioral therapy seem to have the best results in preventing and reversing symptoms of this disorder.
  • Group Therapy – joining with others who may experience similar symptoms helps to relieve any feelings of isolation, while offering mutual support for habits, addictions and impulse-control problems such as with trichotillomania.
  • Family Therapy – seeking to uncover the potential root cause for behavior disorders can be effective with family therapy. This type of therapy can promote healing on many different levels for everyone involved.