Health & Fitness

Trichotillomania: A Better Understanding of the Causes and Treatment

Trichotillomania, classified under the Obsessive-Compulsive disorders, is a mental disorder that makes patients have an irresistible and a recurrent urge to pull their hair from the eyelids, scalp, and other body areas with hair. Attempts to decrease or stop the hair-pulling are often met with aggressive resistance.


When to Seek Medical AttentionTrichotillomania results in partial or complete hair loss in patches especially around the scalp and there is a varying degree of hair loss in the eyelashes and eyebrows. This disorder is recurrent over a prolonged period of time if left untreated and can lead to significant hair loss. And, this has been known to interfere with the occupational and social functioning of the patients. 

The symptoms of Trichotillomania are easy to manage for some people but they get overwhelming for others. 


Trichotillomania is primarily characterized by irresistible and recurrent hair pulling. This hair pulling occurs in any or all hair-growing regions of the body with the most common being the scalp, eyelashes, and eyebrows. Also, it occurs in the pubic regions and sometimes even facial hair. Other observable symptoms include:

  • Hair loss
  • Chewing or biting the pulled hair
  • Obsession with pulling certain texture of hair
  • Tension when or before the hair pulling
  • The relieving feeling after pulling
  • Twirling around with pulled hair
  • Shame in pulling (occurs mostly in private)

Treating Trichotillomania

Treating hair pulling is often complex and requires patience and practice. When starting out with treatment, symptoms might come and go for some patients- don’t be discouraged. Patients seeking to experience no more hair-pulling should make sure they try a reliable and effective strategy that works. Some treatment options include:

  • Relaxation Training: Calming the central nervous system to manage stress triggers is the focus of this strategy.
  • Deep breathing: Training of patients to focus and engage in deep breathing has been known to increase relaxation and relieve tension.
  • Process-Oriented Therapy: Exploring the triggers beneath and any emotional state that precipitates trichotillomania has been an effective therapy. 
  • Reversing Habit: Affected people are made aware of the negative outcomes of hair pulling and the primary goal becomes getting them to pick up more productive behaviors. In essence, they become more aware of the triggers and from there they are guided on ways to avoid them. 
  • Medication: There are no known medications specifically for Trichotillomania, yet. But, SNRIs have been effective in treating triggers including anxiety. 
  • Cognitive Therapy: This strategy is aimed at debunking common myths relating to trichotillomania to help patients have a more positive attitude towards treatment. 
  • Self-Awareness Training: people are made to be more aware of their hair pulling and frequency. This way, they help in becoming part of formulating solutions.

Emotional Explanation

Trichotillomania is accompanied by or triggered by certain emotional states. It is triggered by emotions that include boredom, tension, anxiety, and stress. And, pulling often results in pleasure, a feeling of instant gratifications, and feeling relieved. 

There are degrees of awareness in Trichotillomania. 

Focused Hair Pulling: Some people will pull their hair with the focused intention of experiencing relief and releasing tension. They will pull certain texture types of hair and may include some specific rituals. 

Automatic Hair Pulling: A person could be engaged in a mindless activity, watching TV, or just bored and they subconsciously engage in hair-pulling. 

Mixed Hair Pulling: Some patients will engage in both of the above behaviors. Notably, many people that are diagnosed with hair pulling also have been reported to skin picking, lip chewing, and other repetitive body-focused behaviors. 

Prevalence of Trichotillomania

The prevalence of trichotillomania in both adolescents and adults is around 2% with females being more affected. The onset of trichotillomania is observed from the early stages of puberty. The disease then takes a character of its own and could become chronic. However, some people will experience warning symptoms over time. 

While there is a need for more research, preliminary studies have suggested that there is a genetic element in play with trichotillomania being more common among people whose relatives have varying degrees of obsessive-compulsive disorders. 

Risk Factors of Trichotillomania

  • People with other mental disorders including anxiety and depression are more likely to have trichotillomania.
  • Trichotillomania occurs at the onset of puberty usually between ages 10-13.
  • It is triggered by high-stress in many patients.
learn to stop pulling your hair

When to Seek Medical Attention

Trichotillomania has negative outcomes in the occupational and social functioning of most patients. For this reason, it is vital that one seeks help as soon as possible as it needs treatment options. Essentially, trichotillomania doesn’t just go away unless treated. 

Trichotillomania is a disorder that one should learn to manage triggers and symptoms and soon as possible. And, seeking treatment is advised as it is a disorder that could turn chronic. 

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Susan Harris

By Susan Harris

Susan Harris is the owner of Rooted Mama Health. She is the mother to two amazing children and wife of a loving husband. She strives to provide the world with all the information they need to live a happy and health lifestyle.