Trichotillomania (TTM or “trich”) is a disorder
that results in compulsive hair pulling from the scalp,
eyelashes, eyebrows, or any other parts of the body, causing
bald patches. Hair pulling varies greatly in severity, location
on the body, and response to treatment.
TTM is currently described as a “body-focused
repetitive behavior” (BFRB) along with skin picking and nail
biting. Experts no longer consider it a form of
Obsessive-Compulsive Disorder or self-injurious behavior. Its
official classification and diagnostic criteria are currently
What are the Symptoms of Trichotillomania?
A person with trichotillomania cannot control or
resist the urge to pull out his or her body hair. Other
symptoms that might occur with this disorder include:
A sense of
tension before pulling hair or when trying to resist the
urge to pull hair
A feeling of
relief, satisfaction, and/or pleasure after acting on the
impulse to pull hair
bare patches where the hair has been pulled out
other associated behaviors such as inspecting the hair root,
twirling the hair, pulling the hair between the teeth,
chewing on the hair, or eating hair (called trichophagia)
Often, people who have trichotillomania deny they
have a problem and may attempt to hide their hair loss by
wearing hats, scarves, and false eyelashes and eyebrows.
and When Does Trichotillomania Start?
Compulsive hair-pulling often occurs at the ages
of 12-13; although it is not uncommon for it to start at a much
younger or older age. Frequently, a stressful event can be
associated with the onset, such as: change of schools, abuse,
family conflict, or death of a family member. The symptoms also
may be triggered by pubertal hormone changes.
Does Trichotillomania Affect Both Men and Women?
The hair-pulling behavior affects approximately 1
in 50 people, 90 percent of those are women,
according to current statistics on the disease from the
Trichotillomania Learning Center (TLC). Some experts believe
this is because symptoms are less noticeable in men with short
hair and/or male pattern baldness. Men are also less likely to
seek medical attention, so statistics may be skewed.
What Causes Trichotillomania?
The cause of trichotillomania is not yet known,
but it is likely to involve both biological and behavioral
factors. Research has identified a potential link between
impulse control disorders, such as trichotillomania, and
specific brain chemicals called neurotransmitters.
Neurotransmitters help nerve cells in the brain send messages to
each other. An imbalance of these chemicals can affect how the
brain controls impulses. It also is believed that stress may
trigger the impulsive behavior, and that some individuals
continue the behavior out of habit.
Individuals with trichotillomania may also
experience other disorders such as depression or anxiety. This
suggests that there may be a link between these disorders and
the development of trichotillomania. In addition, the risk of
developing trichotillomania is slightly higher for those who
have relatives with the disorder, suggesting a hereditary
How is Trichotillomania Diagnosed?
If signs and symptoms of trichotillomania are
present, a physician who observes hair loss or a skin or scalp
rash from the pulling can make the diagnosis. There are no
tests to diagnose trichotillomania, although clinical tests may
be employed to rule out other medical causes for the hair loss.
If trichotillomania is suspected, the physician might refer the
person to a health care professional who is trained to evaluate
and treatimpulsive control disorders.
What is the Treatment for Trichotillomania?
Although no single treatment is effective for
everyone, a number of treatment options are available.
Prescription medications and cognitive behavioral therapy are
the most successful options.
Is the Hair Loss Permanent?
In extreme cases of prolonged and severe pulling,
hair loss can become permanent. In milder cases hair keeps
re-growing, although facial hair such as eyelashes and eyebrows
notoriously take longer to grow back. A dermatologist can
confirm hair follicle health and offer a prognosis for hair
Who Can Help Me
with My Hair Loss?
The best approach to cover or hide bald patches is to seek the
help of a non-surgical hair replacement specialist. We, at
Advanced Hair Solutions, know from our experience how stressful
and disturbing hair loss can be. We are dedicated to providing
the most innovative, cost-effective solution for keeping your
stylish appearance after hair loss and will direct every bit of
our combined skills, unsurpassed knowledge and creative
innovation to work for you. We invite you to a private,
complimentary consultation to discuss the best solutions for
your hair loss.
Does Trichotillomania Lead to Other Problems?
During adolescence, which is an especially
critical time for developing self-esteem, some teenagers
encounter ridicule from family, friends, or classmates, while
feeling shame over their inability to control the habit. Even a
small bald patch can cause long lasting problems with
psychological development. Although many people with
trichotillomania overcome the condition, others continue to
suffer in shame and silence.
Where Can I Go for Help?
Many people with
trichotillomania report feeling alone in their experience of
hair pulling. It may help to join a support group for people
with trichotillomania so that you can meet others with similar
experiences and who can relate to your feelings. You might ask
your doctor for a recommendation or visit the Trichotillomania
Learning Center's website at
find a support group. Family and friends of people with
trichotillomania also may benefit from group therapy.
What Other Help Can TLC Provide?
The Trichotillomania Learning Center is a
national nonprofit organization whose mission is to end the
suffering caused by hair pulling and skin picking disorders.
Information provided by TLC is guided by a Scientific Advisory
Board comprised of expert clinicians and researchers in the
Some of their services include:
Local Treatment Provider referrals
Online and In-Person Support Groups for
children, parents, and adults
Phone and Email Support to answer your
Educational Events around the country for
pullers, their families, and treatment professionals
Informational Publications – Brochures,
Books, DVD’s, Newsletter, and Website.
For further information, contact the
Trichotillomania Learning Center (TLC) by phone: 831-457-1004 or