Understanding Trichotillomania


trichotillomaniaTrichotillomania is a type of impulse control disorder, where sufferers have the uncontrollable urge to pull out their hair. Hair-pulling typically occurs on the scalp of the head, though it is not uncommon for sufferers to target other regions of the body, such as the arms, eyelids and eyebrows.

Common Causes of Trichotillomania

There are two varying degrees of awareness in trichotillomania: Automatic & Focused.

In automatic trichotillomania, sufferers are unaware of their hair-pulling tendencies. This may result in gradually noticeable signs of hair loss, which may be an alarming sight. On the other hand, sufferers of focused trichotillomania are fully aware of their hair-pulling habits and use them as a form of catharsis or relief from emotional stress.

Symptoms of Trichotillomania

The signs of trichotillomania are often subtle and gradual.

Common signs of trichotillomania include:

Recurring habit of chewing or biting hair that are pulled out.

A tension or urge to pull hair out, which causes slight bodily resistance when ignored.

The presence of thinning, shortened or bald patches of hair on the body.

Pleasure derived from hair-pulling

Satisfaction from pulling textures similar to human hair, i.e. fine tassels and synthetic bristles.

Treatments for Trichotillomania

There are a few available treatment options which reduce or stop hair-pulling tendencies. These usually focus on the psychological aspect of the sufferer.

Habit Reversal Training

This is often prescribed as the primary treatment for trichotillomania. Habit reversal training identifies the key triggers of hair-pulling and redirects responses thorough healthier outlets such as exercise or simple actions such as fist-clenching.

Cognitive Therapies

Cognitive behavioral therapies are aimed at fixing faulty thought processes behind hair-pulling. Treatment is centered on correcting distorted thought systems -i.e. the more hair pulled, less problems in life.

Acceptance & Commitment Therapy (ACT)

Advanced trichotillomania treatment may involve ACT, which focuses on consciously accepting the presence of a habit or hair-pulling problem. The conscious recognition of hair-pulling responses creates stronger awareness and self-acceptance, which paradoxically reduces stress levels and hair-pulling urges.


Selective serotonin reuptake inhibitors (SSRIs) curb emotional responses that contribute to hair-pulling habits. However, antidepressants should be seen as a last resort due to their long list of negative side effects, which include insomnia and long-term weight gain.

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