• Jacob West

What Is Trichotillomania and What Can Be Done About It?

Trichotillomania is a condition in which the person suffering from it feels a compulsion to pull hair. The hair that is pulled can be from any part of the body, but is typically either from the eyelashes, eyebrows, or scalp. The condition affects up to eight million people in the U.S. annually.

What Is Trichotillomania

The mechanism whereby people impulsively pull hair seems to be rooted in anxiety. When the anxiety reaches a certain level, the person impulsively pulls out their hair, resulting in relief from the tension. However, this relief is only temporary. In time, the tension returns, pushing the person to pull hair again.

It is considered a type of impulse disorder similar to obsessive-compulsive disorder or pathological gambling.

The amount of hair pulled can vary from incidence to incidence. One time there may be only a few hairs pulled. At other times, a sufficient amount of hair can be pulled to cause patches of baldness. This obvious and very visible result of the behavior can cause a lot of anguish for the person. It can lead to very significant problems in social contacts and at work.


There is no consensus among professionals regarding the cause of trichotillomania. Clearly, there is no single cause.

One of the potential causes of the condition is the presence of anxiety, stress, and/or tension. As it builds, the compulsion to do something to relieve the emotion grows. Some people choose to pull hair. The behavior appears to bring temporary relief to the individual.

The finding that people who suffer from trichotillomania also have family members with the condition lends credence to the idea of a genetic basis for the disorder. Several genes have become the focus of research attention currently. However, no direct evidence has been found at this point for any single gene to be responsible for the condition.

There is a possibility that an underlying genetic predisposition may be present in those who suffer from trichotillomania. In order for this underlying predisposition to lead to the condition, some type of stress has to come into the person’s life to trigger it.

Another possible cause for the condition has to do with it being related to some other impulse condition such as thumb sucking. This indicates it may be a habit learned from other habits the person has or had in the past.

Some professionals believe hair pulling may have begun as a response to some childhood trauma. If this viewpoint is true, the hair pulling may serve as a way of self-comforting.

Evidence exists for neurological or biological bases for the development of trichotillomania. This evidence suggests an imbalance or deficiency in neurotransmitters to be the foundation for the condition. Serotonin, the “feel good” chemical in the brain, may be at low levels in those who suffer from trichotillomania.

Related findings that support a biological basis for the condition show that some people who suffer from it have abnormalities in their brains. This is only true for some people with trichotillomania, but still has been found in a small number.

Other professionals believe there may be a hormonal basis for the condition. This view is supported by the typical age of onset for symptoms being in pre-adolescence, the time when the youngster’s body is becoming flooded with hormones that come with puberty.

Who Gets This Condition?

The most typical age of onset for trichotillomania is eleven. Children as young as four years of age and adults as old as 60 have suffered their first experience with this condition. Both males and females are susceptible. More females than males have been diagnosed with it, but this may be artificial. Men typically don’t report or seek help for symptoms as frequently as women. Thus, the incidence may be equal between men and women.

Children are up to seven times more likely to have trichotillomania than adults.

What Can Be Done?

Trichotillomania is considered to be a chronic condition. It has been known to afflict individuals for as long as 20 years.

This condition is not one that individuals can stop by themselves. The feeling of pleasure and relief that comes with hair pulling with these individuals is sufficient reward to continue the behavior.

However, there are treatments that are effective. One facet of these treatments is medication. There is no medication specifically designed to target trichotillomania. But those medicines designed to decrease anxiety often are helpful in reducing the anxiety that appears to trigger the hair pulling.

Another facet of effective treatment is psychotherapy. Cognitive behavior therapy (CBT) seems to be the best approach. A form of CBT called Habit Reversal Training appears to work very well.

In this approach, the belief is that hair pulling is a behavior learned to certain triggers. And these triggers are unknown to the person suffering from the condition. The first thing a person must do in this approach is to learn to recognize these triggers. Then, the person learns to substitute alternative behaviors for hair pulling in the presence of the triggers.

Another form of CBT that is effective is called Mindfulness Based CBT. In this approach, the person learns simply to accept their impulse to pull hair in response to a triggering event. With no judgment, they learn to tolerate the discomfort brought on by that trigger. Accepting their emotions without hair pulling is the key to this treatment approach.

It's important to keep in mind that no matter what treatment approach is selected, a professional should supervise it and help the person in treatment continue with the work required.

For more information on Trichotillomania, visit trichstop.com.

Image Credits: Pinterest

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