All About Trichotillomania – Hair Pulling Addiction

People with trichotillomania (pronounced “trik-uh-till-uh-may-nee-uh“) have a strong desire to pull out their own hair. It is classified as an impulse control disorder (ICD), which is a type of psychological condition. People with impulse control disorders have a very difficult time not performing certain actions.

What is Trichotillomania?

Although doctors used to think trichotillomania was a rare condition, they now understand that it is a widespread disorder. It tends to affect girls more than boys and usually starts happening around adolescence, although it can start in children as young as one. The “mania” part of trichotillomania comes from the Greek word for madness, but studies have shown that people suffering from this disorder can be otherwise emotionally healthy. Doctors tend to think that the compulsion is caused by an imbalance of chemicals in the brain.

People suffering from trichotillomania tend to pull their hair out by the root from the scalp, eyelashes, eyebrows, or pubic region. While some people prefer pulling out large patches at a time, others pull one strand at a time. This can leave behind small or large bald patches. Some people with the condition like to play with their hair after it has been pulled, while about half of them put the hair in their mouths. Although some people are aware that they’re pulling out their hair, others tend to do it absentmindedly.

It is often hard to understand why someone would want to pull out their own hair or why they can’t just stop doing it when they’re told how damaging it can be. Trichotillomania is a compulsive behavior, which means that it’s difficult to stop. If you have this disorder, you have an overwhelming urge to pull out your hair. Some people with the condition also have other compulsive habits like nail-biting or skin-picking. Others suffer from anxiety, depression, or obsessive-compulsive disorder (OCD). Studies have found that compulsive disorders like trichotillomania and OCD often run in families.

Those with trichotillomania might feel like they are alone in their struggle. They may feel embarrassed, shamed, frustrated, or depressed about their compulsion to pull out their hair and try to hide it from friends and family. It’s important to understand that they’re not doing this because they want to: They’re doing it because they can’t stop.

Hair-pulling addiction can have an extreme effect on self-esteem. Because of their self-consciousness, people with this condition might have trouble dating or making new friends. This can damage a person’s self-image and lead to depression.

What Causes It?

Doctors aren’t sure what causes trichotillomania, but some think that it’s related to OCD. Some experts believe that it is caused by a chemical imbalance with neurotransmitters in the brain. Neurotransmitters let the brain communicate with itself. When there is a problem with neurotransmitters, compulsive behaviors can start to happen and an addiction can begin.

Some people suffering say that they notice a tingling or itching in their skin that is only relieve by hair-pulling. Other people describe the feeling of hair-pulling as “satisfying.” There are many people who do not notice they are pulling their hair until it is too late.

Usually, the relief or satisfaction that comes with hair-pulling is short lived. People with trichotillomania say the urge never goes away for very long. The urge to pull becomes a habit, and habits are very difficult for the brain to stop. Like with most addictions, the longer someone has trichotillomania, the harder it will be to stop.

How To Get Help

Because trichotillomania is an addiction caused by an imbalance in the brain and/or a severe instilled habit pattern, it is not something that can easily be stopped. People with the condition usually need to seek specialized help to get better. With the right professional attention, most people can overcome their strong urges to pull hair. The good news is that hair usually grows back once someone stops pulling it out.

Overcoming a hair-pulling addiction usually requires talk therapy known as cognitive behavioral therapy (CBT). During CBT, therapists will teach people with trichotillomania special techniques to curb their impulses. These techniques will teach them how to recognize their urge to pull before it is too late. This often involves identifying certain “triggers,” or situations that bring up a strong desire to pull. The person then learns how to avoid or change these triggers so that they will eventually go away. Therapists usually want people to keep a detailed record of when they pull or have the urge to pull. They will also work with the patient to help them regain their confidence.

If you’re concerned about trichotillomania, speak to a parent or counselor immediately about getting help.

• Facts for Families: Hair-Pulling (PDF)