Trichotillomania

Trichotillosis; Compulsive hair pulling

Trichotillomania is hair loss from repeated urges to pull or twist the hair until it breaks off. Patients are unable to stop this behavior, even as their hair becomes thinner.

Causes, incidence, and risk factors

Trichotillomania is a type of impulsive control disorder. Its causes are not clearly understood.

It may affect as much as 4% of the population. Women are four times more likely to be affected than men.

Symptoms

Symptoms usually begin before age 17. The hair may come out in round patches or across the scalp. The effect is an uneven appearance. The person may pluck other hairy areas, such as the eyebrows, eyelashes, or body hair.

These symptoms are usually seen in children:

  • An uneven appearance to the hair
  • Bare patches or all around (diffuse) loss of hair
  • Bowel blockage (obstruction) if people eat the hair they pull out
  • Constant tugging, pulling, or twisting of hair
  • Denying the hair pulling
  • Hair regrowth that feels like stubble in the bare spots
  • Increasing sense of tension before the hair pulling
  • Other self-injury behaviors
  • Sense of relief, pleasure, or gratification after the hair pulling

Support groups and internet sites such as the Trichotillomania Learning Center can provide recommended educational material and help persons with trich in maintaining a positive attitude and overcoming the fear of being alone with the disease.