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Trichotillomania (hair pulling disorder)

Trichotillomania, also known as hair-pulling disorder, is a mental health condition characterized by the recurrent and compulsive pulling out of one's own hair, leading to noticeable hair loss. This behavior can be distressing, time-consuming, and may result in significant emotional and physical consequences. Trichotillomania falls under the category of Body-Focused Repetitive Behaviors (BFRBs).



The primary symptom of Trichotillomania is the recurrent and compulsive pulling of hair from various parts of the body. Common characteristics may include:
Repetitive Behaviour:
Engaging in hair-pulling for extended periods of time, often without realizing it.
Focus on Specific Areas:
Most commonly, individuals with Trichotillomania target the scalp, eyebrows, or eyelashes, but other body hair may also be pulled.
Sensory Gratification:
Some individuals may find a sensory satisfaction or relief in the act of pulling.
Sense of Loss of Control:
Feeling unable to stop or control the behaviour, even when there is a desire to do so.
Hair Loss and Damage:
Noticeable thinning or bald patches on the scalp or other affected areas.
Avoidance of Social Situations:
Avoiding situations where others might notice the hair loss, such as social gatherings or public events.
Emotional Distress:
Feeling embarrassed, ashamed, or distressed about the hair-pulling behaviour and its consequences.
Attempts to Conceal the Behaviour:
Wearing hats, wigs, or makeup to cover up areas of hair loss.


The exact cause of Trichotillomania is not fully understood, but several factors may contribute:
Genetic Predisposition:
Some individuals may have a genetic vulnerability to developing BFRBs.
Stress and Anxiety:
Trichotillomania can be a way to cope with stress, anxiety, or other emotional challenges.
Sensory Gratification:
The act of pulling hair may provide a sensory satisfaction or relief.
Perceived Imperfections:
A heightened focus on perceived flaws in hair texture or appearance.
Traumatic Events:
Past trauma or high-stress situations may contribute to the development of Trichotillomania.


A diagnosis of Trichotillomania is typically made by a mental health professional, such as a psychiatrist or psychologist. The diagnosis is based on a thorough assessment that includes a detailed clinical interview, observation of behaviour, and, in some cases, the use of standardized assessment tools. It's important to rule out other conditions with similar symptoms, such as obsessive-compulsive disorder (OCD).


Treatment for Trichotillomania often involves a combination of therapies:
Cognitive-Behavioural Therapy (CBT):
This type of therapy helps individuals identify and challenge negative thought patterns, develop coping strategies, and gradually reduce or stop the hair-pulling behaviour.
Habit Reversal Training (HRT):
A specific form of CBT that focuses on replacing the hair-pulling behaviour with alternative, healthier responses.
Exposure and Response Prevention (ERP):
Gradual exposure to triggering situations or stimuli, allowing individuals to practice resisting the urge to pull.
In some cases, medications like SSRIs (Selective Serotonin Reuptake Inhibitors) may be prescribed to help manage symptoms, particularly if there are co-occurring anxiety or mood disorders.
Support Groups:
Joining a support group or seeking peer support can provide a sense of community and understanding.
Professional Hair Care:
Seeking the assistance of a hairstylist or dermatologist for guidance on hair care and management.
Early intervention and consistent, structured support are crucial for managing Trichotillomania. The goal is to help individuals develop healthier coping mechanisms and reduce or eliminate the hair-pulling behaviour.

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