Trichotillomania: Why You're Pulling Your Hair Out

You have been pulling your hair out since you were a kid. You are ashamed that you do this and you want to stop, but you feel a constant hair-pulling urge. Or you may not even realize when you do it. You may have trichotillomania.

Trichotillomania is a type of mental health condition known as an impulse control disorder. Impulse control disorders are conditions in which you have strong, uncontrollable urges to take part in self-destructive behaviors. Pyromania (the urge to set fires) and kleptomania (the urge to steal) are other examples of impulse control disorders.

Is Stress Behind Your Hair Loss?

Researchers are not sure exactly what causes impulse control disorders such as trichotillomania. But it is believed that chemical imbalances in the brain are likely to be involved. And there also may be a genetic component, since trichotillomania sometimes runs in families.

Symptoms of Trichotillomania

Symptoms of trichotillomania are not always the same. Some people pull their hair out in large clumps, while others pull out one strand at a time. Some people with trichotillomania are aware that they are pulling their hair out, and even get a pleasurable sensation when they do it — sometimes likened to scratching an itch. But others do it unconsciously without even thinking about it. Some people tend to inspect the hair strand after pulling it, and some put the strand in their mouth, and may even swallow the hair.

People with trichotillomania may pull hair out of their scalp or from their eyebrows, eyelashes, or other parts of their body.

In general, common trichotillomania symptoms include:

• Repeatedly pulling out hair by the root
• Bald spots or noticeable hair loss
• Sensations in the scalp or skin that are only relieved by hair pulling
• A build-up of tension along with an urge to pull out hair
• A satisfying feeling associated with pulling out hair
• Shame or embarrassment about hair pulling, even denying what they are doing

Who Has Trichotillomania?

Trichotillomania is a relatively rare condition, affecting between 1 and 4 percent of Americans.

Trichotillomania affects more women than men. Most people with trichotillomania began pulling their hair out during adolescence, around the age of 12 or 13. But people can begin hair pulling as early as age 1, and it can also start later in life.

Treatment Options and Coping With Trichotillomania

If you suspect that you or a loved one has trichotillomania, see your doctor. He can rule out other conditions that may be resulting in hair loss, and give you options for managing trichotillomania.

Trichotillomania is a mental health condition, and most people will need professional help to learn how to control their hair pulling impulses. Common treatment options for trichotillomania include:

• Cognitive-behavioral therapy. In cognitive-behavioral therapy (sometimes called “talk therapy”) for trichotillomania, a therapist will teach you how to recognize the growing urge to pull out your hair, and learn how to manage it before it becomes too strong. You may learn that certain situations trigger your hair-pulling urges, and you can avoid or modify these situations.
• Medications. Sometimes doctors prescribe medications, such as selective serotonin reuptake inhibitors (SSRIs), to help people control their hair pulling urges. These medications alter your brain chemistry to make it easier to resist hair-pulling impulses.
• Behavioral modification. Your doctor may recommend that you find things to do with your hand, such as squeezing a stress ball or knitting, at times when you are likely to have a strong urge to pull out your hair.

The Psychological Effects of Hair Loss

Overcoming trichotillomania can be difficult. In addition to working with your doctor to help manage your condition, it can help to join a support group made up of other people who are in a similar situation as you. The Trichotillomania Learning Center provides a listing of trichotillomania support groups around the world.

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