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Educational Videos

What is Trichotillomania?

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 being revised.


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

  • Presence of bare patches where the hair has been pulled out

  • Presence of 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.


How 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 factor.


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 regrowth.


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 www.trich.org to 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 field. 

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 questions

  • 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 online at www.trich.org


Additional Resources:

StopPulling (online behavioral program):  www.StopPulling.com

TrichWorld (social networking):  www.trichworld.com

Association for Behavior and Cognitive Therapies (therapist database):  www.abct.org


Educational Videos:

Compulsive hair puller?  NOT YOUR FAULT!  Trichotillomania could be caused by GENETIC FACTORS researchers say!



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