Hair Pulling Disorder

Trichotillomania – (trik-o-til-o-MAY-nee-uh)
also known as Hair Pulling Disorder

Trichotillomania is a mental disorder classified as a type of Impulse Control Disorder in which a person cannot resist the recurrent urge to pull out their hair, whether it be from their scalp, eyelashes, or eyebrows, or other areas of their body, despite wanting/trying to stop.

According to Psycom one of the results from hair pulling of the face is a complete or partial removal of the eyebrows and eyelashes. When hair is pulled from the scalp it can lead to patches of hair loss.

For those of us who do not suffer with this disorder it is hard to fathom how someone can do this to themselves. How can they cause this kind of injury? How can they do this? We may even ask them those questions. Don’t they know they are doing harm to their own bodies?

Yes, they do know but that knowledge does not stop them from doing so.

It causes them distress and most likely interferes with their social life and career.

The most common symptoms to look for are:

  • Pulling the hair
    • This can happen in any area of the body
    • Most common sites are:
      • Scalp
      • Eyebrows
      • Eyelids
    • Less common areas are:
      • Facial
      • Pubic
      • Peri-rectal regions

Other less common symptoms are:

  • Repeated attempts to decrease or stop hair pulling
  • Distress which leads to social and career situations
  • Stressed before the hair pulling, when trying to resist the behavior
  • Relief after hair pulling
  • Noticeable hair loss
  • Playing with pulled hair
    • Even rubbing it across the skin
  • Biting, chewing, or eating the pulled hair
  • Pulling certain types/textures of hair
  • These behaviors most often take place in private

This is a coping mechanism developed to help them with their anxiety, boredom, stress, tension. The behavior leads to gratification, relief, or pleasure.

For many with this behavioral disorder this is not the only body-focused repetitive behaviors. Other behaviors to look for include:

  • Picking of skin (next week’s post)
  • Nail biting
  • Lip chewing

Research shows the behavior usually sets in at puberty and is chronic, though symptoms can lessen only to increase again at a later date throughout the person’s lifetime.

While the exact cause of this disorder is unknown some of the risk factors may include:

  • Age – it usually sets in between 10 – 13 years of age and can continue throughout the person’s lifetime.
  • Other mental health disorders – you will usually see they also deal with anxiety, depression, or OCD.
  • Stress – high levels of stress have been known to trigger it.

How is it treated? According to Psycom some of the treatments are:

  • Habit reversal: This is often the primary treatment of trichotillomania. Individuals learn how to recognize situations where they are likely to pull hair and substitute other behaviors instead. Many people use journaling, alerts, and other strategies to increase awareness of triggers. Instead of pulling hair, a person might substitute behaviors such as clenching fists or snapping an elastic band on the wrist.
  • Cognitive therapy: This type of therapy can help people explore distorted beliefs related to hair pulling.
  • Self-awareness training: Individuals learn to become more aware of their hair pulling patterns by tracking when they pull and detailing emotions and other important information.
  • Relaxation training: This helps people learn to focus on and calm their central nervous systems in response to stress triggers.
  • Deep breathing training: Learning the proper way to engage in deep breathing helps increase relaxation and focus.
  • Process-oriented therapy: Talk therapy can be effective in helping people explore their triggers and emotions beneath the pulling.
  • Medication: While there are no medications specific to the treatment of trichotillomania, SSRIs and SNRIs can be used to treat some of the accompanying symptoms of anxiety.
  • Family therapy: For children and adolescents, family therapy helps parents learn to better respond to and manage symptoms.
  • Group therapy: Trichotillomania can feel isolating. Groups help people connect with others enduring a similar struggle and provide support for one another.

To learn more about this disorder and how you can help those who suffer please visit the National Organization for Rare Disorders.

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