Trichotillomania (Hair-Pulling Disorder): Causes - Symptoms- Diagnosis -Treatment

 What is Trichotillomania (Hair-Pulling Disorder)(TTM)?

Trichotillomania (frequently abbreviated as TTM) is a mental fitness ailment wherein someone compulsively pulls out or breaks their own hair. This situation falls under the classification of obsessive-compulsive ailment (OCD). When it’s extreme, it frequently has extremely terrible effects on a person’s happiness, nicely-being and usual greatness of existence.

Trichotillomania (stated: trick-oh-until-oh-may also-nee-ah), additionally known as trich or on occasion just TTM, is a circumstance in which someone can’t face up to the urge to pull out their hair, either on their head from the scalp,  eyebrows or eyelashes or from different components of their frame together with their armpits or genital vicinity.

The maximum common technique of hair pulling among sufferers is to apply their palms. However, some patients additionally use tweezers or other contraptions.

What is Trichotillomania (Hair-Pulling Disorder)(TTM)?
Hair-Pulling Disorder

Although Trichotillomania is indexed under ‘Obsessive-Compulsive Disorder and Related Disorders’ within the latest Diagnostic and Statistical Manual of Mental Disorders (DSM), similarly to pores and skin picking, it isn't exactly similar to Obsessive-Compulsive Disorder and might higher be indexed as a ‘frame-centered repetitive behavior’, in reality it turned into once considered as an impulse manage sickness.

So at the same time as there are a few compulsive and ritualistic similarities between the two there are also crucial differences. Primarily, OCD is driven by means of unwanted intrusive thoughts (the obsessions), for example fears of awful things going on, wherein compulsions are achieved in an attempt to prevent bad things from happening. Whereas Trichotillomania is characterized normally via frame-targeted repetitive behavior (pulling at hair) to reduce tension/pressure, or even out of dependency, rather than being initiated with the aid of an undesirable intrusive notion.

People with the trouble experience an extreme urge to tug their hair out and that they enjoy developing anxiety till they do. After pulling their hair out, they experience relief. Sharing similarities with skin picking disorder, someone may additionally every now and then pull their hair out in reaction to a traumatic state of affairs, or it could be accomplished without simply thinking about it.

  1. Nervous system

Medical terms

  • Trichotillomania (trik-o-til-o-MAY-nee-uh), additionally known as hair-pulling disease, is a mental disease that involves recurrent, impossible to resist urges to drag out hair out of your scalp, eyebrows or different areas of your body, despite trying to stop.
  • Hair pulling from the scalp often leaves patchy bald spots, which causes sizable misery and might intervene with social or paintings functioning. People with trichotillomania may go to excellent lengths to hide the lack of hair.
  • For a few human beings, trichotillomania can be moderate and commonly achievable. For others, the compulsive urge to tug hair is overwhelming. Some treatment alternatives have helped many humans reduce their hair pulling or stop completely.
  • Trichotillomania is an impulse control disorder in which a person has the repeated urge to pull out his or her hair from any area of the body Some people with this condition pull out their eyelashes eyebrows scalp hair and/or other body hair Sometimes it's associated with the compulsive eating disorder bulimia nervosa People with trichotillomania may pull out their hair because of stress boredom or anxiety.

Trichotillomania (TTM or "trich") is an impulse control disorder characterized by the repetitive urge to pull out one's hair The severity of this problem can range from mild involving the pulling out of a few hairs at a time to severe resulting in noticeable bald patches Those suffering with trichotillomania may also pick their skin and bite their nails Trichotillomania can be present for as little as three months to for over 40 years with an average duration of about 15 years Because it is estimated that only 10% of people who suffer with hair-pulling disorder seek treatment it is likely that there are far more individuals dealing with this condition than those who.

Symptoms Trichotillomania (hair-pulling disorder)(TTM)

People with trich experience a severe urge to pull their hair out and they enjoy growing tension until they do. After pulling their hair out, they experience comfort.

An individual may also every so often pull their hair out in response to a demanding scenario, or it is able to be achieved without clearly considering it.

Signs and symptoms of trichotillomania often include:

  • Repeatedly pulling your hair out, usually out of your scalp, eyebrows or eyelashes, but once in a while from other body regions, and websites may additionally vary over time

  • An increasing sense of tension before pulling, or when you try to resist pulling

  • A sense of pleasure or relief after the hair is pulled

  • Noticeable hair loss, including shortened hair or thinned or bald regions at the scalp or other regions of your body, inclusive of sparse or lacking eyelashes or eyebrows

  • Preference for specific kinds of hair, rituals that accompany hair pulling or patterns of hair pulling

  • Biting, chewing or eating pulled-out hair

  • Playing with pulled-out hair or rubbing it across your lips or face

  • Repeatedly trying to stop pulling out your hair or trying to do it less often without success

  • Significant distress or problems at work, school or in social situations related to pulling out your hair

Many humans who've trichotillomania also pick their pores and skin, chunk their nails or chew their lips. Sometimes pulling hairs from pets or dolls or from materials, together with clothes or blankets, can be a sign. Most humans with trichotillomania pull hair in non-public and usually try to disguise the disorder from others.

For human beings with trichotillomania, hair pulling can be:

  • Focused. Some people pull their hair intentionally to relieve tension or distress — as an example, pulling hair out to get alleviation from the overwhelming urge to tug hair. Some humans might also increase difficult rituals for pulling hair, inclusive of locating simply the proper hair or biting pulled hairs.

  • Automatic. Some people pull their hair without even knowing they're doing it, which includes when they may be bored, reading or watching TV.

The same man or woman may additionally do each centered and automatic hair pulling, depending on the state of affairs and temper. Certain positions or rituals may additionally trigger hair pulling, inclusive of resting your head in your hand or brushing your hair.

Trichotillomania may be related to emotions:

  • Negative emotions. For many humans with trichotillomania, hair pulling is a way of coping with bad or uncomfortable feelings, together with strain, anxiety, anxiety, boredom, loneliness, fatigue or frustration.

  • Positive feelings. People with trichotillomania frequently locate that pulling out hair feels fulfilling and affords a measure of comfort. As a result, they keep dragging their hair to maintain those tremendous emotions.

Trichotillomania is an extended-term (chronic) ailment. Without treatment, signs can range in severity over time. For example, the hormonal changes of menstruation can worsen signs and symptoms in girls. For a few humans, if no longer handled, signs and symptoms can come and opt for weeks, months or years at a time. Rarely, hair pulling ends inside a few years of starting.

When to see a doctor

If you cannot forestall pulling out your hair or you experience being embarrassed or ashamed by the way you look because of your hair pulling, talk to your medical doctor. Trichotillomania isn't only a terrible addiction, it is an intellectual health disorder, and it's unlikely to get better without remedy.

Causes Trichotillomania (hair-pulling disorder)(TTM)

The cause of trichotillomania is presently unknown and may be a result of an aggregate of genetic and environmental elements. Risk elements for trichotillomania may consist of a family history of trichotillomania and strain. Trichotillomania can also be associated with different conditions, including obsessive compulsive sickness (OCD), tension, and melancholy. 

The cause of trichotillomania is unclear. But like many complicated disorders, trichotillomania possibly results from a combination of genetic and environmental elements.

While experts suspect several viable elements should result in TTM, there aren’t any shown reasons for this situation. Some of the suspected elements include:

  • Genetics. TTM may also happen due to positive DNA mutations. More research is needed to verify this.

  • Changes in brain structure or chemistry. People with TTM frequently have changes to positive regions of their brains or differences of their mind chemistry.

  • Coping mechanism. Many human beings with TTM describe it as beginning after an annoying time of their life. Others describe it beginning because of boredom and that pulling their hair has become a dependency over time.

Risk factors Trichotillomania (hair-pulling disorder)(TTM)

Hair-pulling disorder also known as trichotillomania is a compulsive disorder characterized by recurrent pulling out of one's hair. It can begin at any age and affects men and women equally People with this condition often pull their hair from the head, eyelashes or eyebrows.

These factors tend to increase the risk of trichotillomania:

  • Family history. Genetics may additionally play a position inside the improvement of trichotillomania, and the sickness might also occur in the ones who've a near relative with the ailment.

  • Age. Trichotillomania usually develops simply earlier than or all through the early teens — most usually between the a long time of 10 and thirteen years — and it is often a lifelong problem. Infants also can be liable to hair pulling, but that is commonly moderate and is going away on its own without treatment.

  • Other disorders. People who've trichotillomania might also have other issues, which includes melancholy, anxiety or obsessive-compulsive ailment (OCD).

  • Stress. Severely annoying conditions or activities may additionally cause trichotillomania in a few humans.

Although a long way greater ladies than men are handled for trichotillomania, this may be due to the fact girls are much more likely to be seeking for clinical advice. In early childhood, boys and girls seem to be equally affected.

Complications Trichotillomania (Hair-Pulling Disorder)

Although it can no longer seem mainly extreme, trichotillomania can have a major bad impact on your life. Complications might also include:

  • Emotional distress. Many human beings with trichotillomania feel shame, humiliation and embarrassment. They can also enjoy low vanity, melancholy, tension, and alcohol or street drug use due to their condition.

  • Problems with social and work functioning. Embarrassment because of hair loss may also lead you to keep away from social sports and process possibilities. People with trichotillomania may also put on wigs, fashion their hair to cover bald patches or wear false eyelashes. Some humans may avoid intimacy for worry that their situation can be found.

  • Skin and hair damage. Constant hair pulling can cause scarring and different damage, along with infections, to the skin to your scalp or the specific location where hair is pulled and may permanently have an effect on hair growth.

  • Hairballs. Eating your hair may additionally lead to a massive, disheveled hairball (trichobezoar) for your digestive tract. Over a duration of years, the hairball can motivate weight reduction, vomiting, intestinal obstruction or even loss of life.

Can my hair recover from trichotillomania?

Trichotillomania is a disorder that involves pulling out and/or cutting your hair It can cause extensive damage to the affected area including scarring and balding While there is no scientific proof that trichotillomania causes permanent hair loss it might be difficult to grow back the lost hair if you have been pulling your hair out for an extended period of time However even if you have noticeable bald spots your body will still produce new hair follicles With proper treatment you should be able to get all your hair back in due time.

How can I grow my hair back after trichotillomania?

Trichotillomania is an impulse control disorder that results in a person pulling out his or her own hair It affects approximately 3.5 percent of the general population and can occur at any age but is most prevalent among adolescents and young adults The most common areas of the scalp affected are the front hairline and eyebrows Areas around the eyes cheeks upper lips arms legs and pubic area may also be pulled out Most people with trichotillomania focus on only one area (for example eyelashes or eyebrows) although some people pull from multiple sites on their bodies.

Does castor oil help with trichotillomania?

Trichotillomania is an impulse control disorder in which people have a strong and irresistible urge to pull out their hair It can be triggered by stress anxiety or boredom and is characterized by recurrent pulling of the hair until it either breaks off or a bald patch is formed People who suffer from this condition often seek ways to hide their bald spots such as dressing in hats or wigs but what they may not realize is that there are natural treatments for trichotillomania that may help reduce symptoms Trichotillomania treatments include therapy medications and natural remedies Castor oil contains ricinoleic acid and oleic acids which promote the healing process Massaging the scalp.

Prevention Trichotillomania (Hair-Pulling Disorder)

TTM is an intellectual health circumstance, which means it isn’t preventable. There’s additionally no recognized way of decreasing your danger of growing it.

Diagnosis Trichotillomania (hair-pulling disorder)(TTM)

In some instances, a “punch biopsy” (in which your healthcare issuer takes a skin sample for lab analysis) is essential to confirm a diagnosis of TTM. This take a look at can also rule out different skin conditions that might be the proper reason for hair loss or hair pulling.

In instances wherein your healthcare issuer suspects a blockage from swallowed hair, you may additionally undergo different diagnostic tests. These encompass imaging tests like an automatic tomography (CT) test, blood testing for anemia and extra.

An assessment to decide if you have trichotillomania may additionally include:

Treatment Trichotillomania (hair-pulling disorder)(TTM)

Treating trichotillomania normally depends on the severity of the circumstance and the medical history of the man or woman. Typically, trichotillomania treatments involve dependency reversal schooling (HRT), cognitive behavioral remedy (CBT), attractiveness and dedication remedy, and using medications under the supervision of an authorized intellectual health expert. Therapies which are focused towards enhancing different mental health issues frequently related to trichotillomania (e.G., despair, anxiety, or obsessive compulsive ailment) may be an essential part of remedy.

HRT is a behavioral therapy and primary remedy for trichotillomania, which teaches an individual to understand their triggers of trichotillomania, substitute their hair pulling behaviors with other behaviors, find new methods to live influenced, and exercise newly discovered avoidance techniques in exceptional situations. CBT may additionally help individuals become aware of and understand any beliefs they'll have in terms of hair pulling, whilst popularity and dedication therapy can assist people in learning to just accept their hair pulling urges without performing on them.

Depending on a person's state of affairs and past treatments, positive medicinal drugs may also be used to manipulate signs of trichotillomania. Some medicinal drugs that can be used in instances of trichotillomania include N-acetylcysteine, that's an amino acid that affects neurotransmitters associated with temper; ordinary antipsychotics, consisting of olanzapine; or antidepressants, such as clomipramine, to assist mitigate symptoms related to trichotillomania.

Research on treatment of trichotillomania is restrained. However, some treatment options have helped many people reduce their hair pulling or forestall entirely.


Types of therapy that may be helpful for trichotillomania include:

  • Habit reversal training. This conduct remedy is the number one treatment for trichotillomania. You learn how to apprehend conditions wherein you are in all likelihood to drag your hair and the way to replace different behaviors as a substitute. For instance, you would possibly clench your fists to assist stop the urge. Other treatment plans can be used alongside dependency reversal training. A variant of this technique, referred to as decoupling, includes quick redirecting your hand from your hair to some other region.

  • Cognitive therapy. This remedy allows you to perceive and take a look at distorted ideals you can have on the subject of hair pulling.

  • Acceptance and commitment therapy. This therapy allows you to discover ways to accept your hair-pulling urges without acting on them.

Therapies that help with different intellectual fitness disorders often associated with trichotillomania, which includes despair, tension or substance abuse, may be a vital part of treatment.


Although no medications are authorized with the aid of the Food and Drug Administration specially for the remedy of trichotillomania, some medicines may also help manage positive signs.

For example, your physician may suggest an antidepressant, inclusive of clomipramine (Anafranil). Other medicines that studies shows may additionally have a few advantage include N-acetylcysteine (as-uh-tul-SIS-tee-een), an amino acid that influences neurotransmitters associated with mood, and olanzapine (Zyprexa), an strange antipsychotic.

Talk together with your health practitioner about any medicinal drug that he or she suggests. The viable advantages of medicinal drugs should always be balanced against feasible side results.

Coping and support

Many humans with trichotillomania report feeling by themselves of their experience of hair pulling. It may also help to enroll in a support organization for human beings with trichotillomania so you can meet others with comparable reviews who can relate to your feelings.

Ask your medical doctor or intellectual fitness expert for advice or take into account searching online for a trichotillomania help organization.

  1. Psychological rehabilitation

Preparing for your appointment

Seeking help is the first step in treating trichotillomania. At first you may see your number one care doctor or a dermatologist. He or she can also refer you to an intellectual fitness expert.

What you can do

Before your appointment make a list of:

  • All the symptoms you're experiencing, Even though they appear unrelated to hair pulling. Trichotillomania can motivate each physical and psychological signs and symptoms. Note what triggers your hair pulling, how you've tried to cope with the trouble, and factors that make it higher or worse.

  • Key personal information, Consisting of any essential stresses or current life changes and whether or not hair pulling runs for your own family.

  • All medications, Vitamins, herbs or other supplements that you're taking, which includes the dosages and how long you have been taking them.

  • Questions to ask your doctor to make the most of your appointment time.

Questions to ask your doctor may include:

  • What might have caused me to develop this disorder?

  • How do you diagnose this condition?

  • Is this something with a view to depart on its own? Is there whatever I can do on my own to enhance my signs and symptoms?

  • What treatments do you recommend?

  • If I decide to take medications, how long will it take for my symptoms to improve?

  • What are the side effects of the medications you're recommending?

  • How much improvement can I realistically expect if I follow your treatment plan?

Don't hesitate to invite different questions at some stage in your appointment.

What to expect from your doctor

Your physician will possibly ask you some questions. Be geared up to reply to them to reserve time to head over any factors you want to be aware of. Your physician may ask:

  • When did your hair first start?

  • Have you tried to stop pulling your hair? What was the result?

  • Are there times or situations that are likely to trigger your hair pulling?

  • What feelings do you have before and after you pull your hair?

  • From where on your body do you pull hair?

  • Do you bite, chew or swallow the hair?

  • How has your hair pulling affected your work, school or social life?

  • Have you had treatment (medication or therapy) for hair pulling or other emotional issues?

General summary

  1. Effective treatments for trichotillomania include a combination of psychotherapy and medication Treatment with medications such as antidepressant or anti-anxiety drugs may be effective in treating the condition Psychotherapy involves working with a therapist who teaches the individual tools to manage the impulses that lead to hair pulling The therapy can also address other problems that may contribute to the disorder including anxiety depression or obsessive-compulsive disorder.

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