Trichotillomania is an impulse control disorder where sufferers compulsively pull out their hair, often from the scalp, eyelashes, eyebrows, or pubic area. It usually begins in childhood or adolescence and may be accompanied by other impulse control disorders. Treatment is usually psychological, with Habit Reversal Training being the most successful form.
Trichotillomania is a rare impulse control disorder in which the sufferer compulsively pulls their hair out. People with trichotillomania most commonly pluck hair from the scalp, eyelashes, eyebrows, or pubic area. While most people with trichotillomania pull out each hair by the root, others may pull out large handfuls at a time.
Trichotillomania usually begins in childhood or adolescence, often coinciding with the onset of puberty. While some children develop hair-pulling habits that diminish with age, other individuals continue the behavior throughout adulthood. It is estimated that between one and three percent of Americans suffer from trichotillomania. Of these individuals, approximately 80% are women.
The direct causes of trichotillomania are unknown; however, many people with the condition also experience similar impulse control disorders, such as skin picking and nail biting. In many cases, individuals also suffer from depressive disorder or obsessive-compulsive disorder. Some evidence suggests that trichotillomania may be genetic or the result of a chemical imbalance. Stress is also thought to play a role, as periods of high stress are known to aggravate the condition.
People with trichotillomania are often embarrassed or ashamed of their behavior, leading them to hide it from others. For this reason, low self-esteem is very common among sufferers. Additionally, compulsive hair removal can lead to bald patches on the scalp or eyebrows, which contribute to the sufferer’s embarrassment and depression.
In some cases, trichotillomania is accompanied by trichophagia, which is the swallowing of pulled hairs. This can result in the formation of a gastric bezoar, also known as a hairball. Gastric bezoars are extremely dangerous and may require surgical removal to prevent intestinal blockage.
Because trichotillomania is a behavioral disorder, treatment is usually psychological. The most successful form of treatment, known as Habit Reversal Training (HRT), focuses on raising patients’ awareness of when and why they pull their hair out. Psychologists therefore aim to train patients to redirect the impulse. In some cases, antidepressants are also effective in treating trichotillomania.
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