Hair Pulling Disorder, Trichotillomania, an Unreported Psychological Issue

The hair-pulling disorder is also known as trichotillomania in the medical community. It is a type of impulse control disorder that involves involuntarily pulling of one’s own hair. It is a chronic disease and faces difficulty in its treatment.

The hair-pulling disorder is noticed most commonly in infants. Children age 9 to 12 years are the most common victims of psychological disease. The repercussions include hair loss and consequently a sense of gratification in most cases. However, in some cases, a person is unaware of his actions so it is not necessary that a person suffering from hair pulling disorder is performing the unwanted action to gain a sense of relief or gratification. It runs in the periphery of obsessive-compulsive disorder commonly abbreviated as OCD.


The symptoms are stark. Evident loss of hair is the prime symptom. The most common and the foremost area affected by it is the scalp. The victim later resorts to pulling eyebrow hair, eyelashes, facial hair, the hair on arms and legs, and pubic hair. Even the hair type of such individuals assume a different form altogether. The hair growth is found to be uneven and the ends of the hair may be blunt and broken; some may be tapered. However, no effect is caused on the density of the hair.

A person suffering from trichotillomania exhibits low self-esteem. In many cases, a person feels he is the only victim of this psychological problem. This is mainly due to the fact that most cases of TTM go unnoticed or unreported.

Drastic consequences of this problem include permanent loss of hair. Another consequence is trichophagia. It is an advanced condition of trichotillomania which involves the ingestion of hair by the person after pulling it. This can lead to gastrointestinal problems.

The activity is performed when the person is in a relaxed state of body and mind. This is usually before sleeping i.e. while lying in bed. In some cases, a person pulls his hair while asleep. This condition is termed as sleep-isolated trichotillomania.


The most common reason for hair pulling disorder is the mental stress which an individual undergoes. Anxiety and depression are other related factors. The obstructive compulsive disorder is commonly encountered in such individuals.


The diagnosis of hair-pulling disorder is an uphill task. This owes to the fact that most cases are gone unreported and many times unnoticed. A person suffering from trichotillomania shall actively conceal his problems. Use of wigs, false eyelashes, eyebrow pencils is very common among such people. The diagnosis is not difficult once the problem is detected. A differential diagnosis is impactful and so is a biopsy. It is noteworthy that the hair pull test in such individuals is always negative.


The treatment involves behavior modification programs and counseling. If you would like to look into possible treatment options for you or a loved one, click here. This can be impactful in earlier stages especially during childhood. In extreme cases help from psychologists and psychiatrists is essential. In many cases, medication for the same is also very impactful. Antidepressants are required to cater to the same. Behavioral therapy is another effective treatment for the hair-pulling disorder.

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