Trichotillomania or hair pulling disorder: symptoms and causes of

You may think that pulling your own hair is just a bad habit, but do you know that it can actually be a disorder? People with hair pulling disorder or trichotillomania have a strong urge to pull out their hair. They experience increasing tension until they pull out a few strands or a chunk of hair, and then feel a sense of relief. It can be a reaction to a stressful situation, but it can also happen without much thought. They not only pull hair from their scalp, but also from other areas, such as their eyebrows and eyelashes. Read on to know all about trichotillomania and ways to stop pulling out your hair.

What is hair pulling disorder?

Hair pulling disorder is also known as trichotillomania, a chronic condition, says psychiatrist Dr Neatu Narang. It is characterized by repeated pulling out of one’s own hair, and most cases go unnoticed until significant hair loss becomes apparent. The lifetime prevalence of this condition, which usually begins in adolescence, is as high as 3.5 percent, according to a study published in StatPearls in 2023.

It is considered a variant of obsessive-compulsive disorder, in which a person has uncontrollable thoughts and engages in repetitive behaviors. Increased tension prior to hair pulling triggers the behavior and then relief or satisfaction for short periods of time, the expert says. There are two types of hair pulling:

• Concentrated pulling: This is where someone does it deliberately to control unpleasant personal experiences.
• Automatic pulling: It happens without the person being aware of it. It usually happens during sedentary activities, such as simply sitting.

Once you stop pulling out your hair, new hair growth may occur. But it can take months or years for the hair to grow back.

What are the causes of trichotillomania?

It is not known what causes someone to develop hair pulling disorder, but some may do it to relieve stress. Someone who has a mother, father or brother or sister with this condition has a greater chance of developing this condition.

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What are the symptoms of trichotillomania?

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

• They also experience an increasing sense of tension before engaging in this behavior.
• They achieve a feeling of relaxation or satisfaction by pulling out their hair.
• If they notice significant hair loss, they make repeated attempts to reduce or stop the hair pulling, but are unable to do so.
• Skin irritation on the affected areas
• Bald spots due to pulling your own hair.

How is hair pulling disorder diagnosed?

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

How to prevent trichotillomania?

The key to preventing hair pulling disorder is the early detection of the individual’s poor stress tolerance and coping skills, says Dr. Narang. Stress management and early intervention to deal with emotional pain can go a long way in preventing hair pulling disorder.

What are the ways to treat trichotillomania?

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

There are no medications approved by the U.S. Food and Drug Administration specifically for its treatment, but habit-reversal training can help. The aim of treatment is to help you replace a bad habit with something that will not harm you, as is the case in Britain National Health Service. This usually involves:

• Keep a diary of your habit of pulling your own hair
• Discover the triggers for hair pulling
• Replacing it with another action, such as squeezing a stress ball when there is an urge to pull hair
• Getting emotional support 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.