Trichotillomania (Hair Pulling)

You suffer from very strong urges to pull out your hair, urges too strong and persistent to be resisted; and since you pull the hairs of your scalp, eyebrows and other parts of your body so often, you have noticeable bald patches or hairless areas on your body.

You feel a great tension before pulling or as you try to resist these urges and when you succumb to your urges your tension turns into pleasure, relief or gratification; and if you’re like many with this disorder, you go to great lengths to conceal your hair loss and so many of the people in your life have no idea of your debilitating condition.

If you suffer from mild trichotillomania, you probably feel frustrated by your disorder, but you can likely control your urges through awareness and concentration. In more serious cases, the urges felt are overpowering and can result in deep feelings of shame and even a curtailment of normal daily activities. People with noticeable hair loss may go to great effort and expense to hide their hairless areas and may avoid also social contact to minimize feelings of embarrassment and shame – in some cases these feelings make it difficult to work or socialize outside of the home, or get needed medical or dental care.¹

Do You Have Trichotillomania?

According to the APA’s manual of mental health disorders trichotillomania is a form of impulse control disorder, to meet a diagnosis of Trichotillomania, you must:

1. Recurrently pull your hair out and this hair pulling must result in noticeable areas of hair loss

2. Feel amplifying tensions just before the hair pulling or as you try to resist the impulse to pull your hair.

3. As you pull your hair out, you must experience pleasure or relief

4. Not have a dermatological or medical condition which explains your need to pull your hair out

5. Not have another mental health disorder which better explains your hair pulling

6. Feel significant distress due to the condition or the disorder must limit your performance at work, in relationships or in other important areas of your life*²

Who Gets Trichotillomania?

In children, trichotillomania occurs equally in both boys and girls, but by adulthood, women are more likely to experience the disorder.

No one knows the exact occurrence rate, though in one study of college students, the disorder was found to occur in 0.6% of students. The Trichotillomania Learning Center puts the incidence rate at a slightly higher 1% to 3% of the general population, or 3 to 9 million Americans. ³

Adults with the disorder often report first onset in adolescence. Some people experience symptoms chronically and continuously, while others experience active periods followed by periods of remission. The site of hair pulling on the body will often change over time. Without treatment, the disorder generally persists chronically, for a lifetime (the exception being small children, who sometimes experience a period of hair pulling that later goes away).

People with a close relative with the disorder are at greater risk themselves to also experience it. ⁴

Swallowing Hair

Some people with Trichotillomania will eat the hairs that are pulled from the body. This can result in hairballs (trichobezoars) which can in turn result in intestinal blockages requiring surgery to remove, and which can be fatal.