Trichotillomania is an impulse control disorder that involves recurrent, irresistible urges to pull out hair from one’s own scalp, beard, eyebrows, eyelashes, pubic hair or other areas of the body, despite trying to stop. The sites may vary over time. It is usually referred to as an obsessive- compulsive disorder but most recently, it has been conceptualized as part of a family of “body-focused repetitive behaviors” along with skin picking and nail biting. Hair pulling from the scalp often leaves patchy bald spots, which causes significant distress and can interfere with self-image, social or work functioning.
The most common symptoms often include:
- Repeatedly pulling hair out, typically from the scalp
- An increased sense of tension before pulling and a sense of pleasure or relief after the hair is pulled
- Shortened hair or thinned or bald areas on the scalp or other areas of the body, including sparse or missing eyelashes or eyebrows
- Biting, chewing or eating pulled-out hair (trichophagia). This is a very dangerous condition that needs to be treated because hair is not digestable in the stomach and can build up into a hair ball. This can severely irritate the stomach lining leading to severe ulceration
- Playing with pulled-out hair or rubbing it across lips or face
Trichotillomania probably results from a combination of genetic and environmental factors. It usually develops just before or during the early teens and is often a lifelong problem. Infants also can be prone to hair pulling and if affects far more women than men.
People who have trichotillomania may also have other disorders, such as depression, anxiety or obsessive-compulsive disorder (OCD) and it is treated with psychotherapy (cognitive-behavior therapy, medications, support groups, alternative therapies etc.)