Trichotillomania

GinaMarie Guarino, LMHC

Trichotillomania

Trichotillomania is a disorder in which an affected person rips out their own hair. The hair-pulling behavior is compulsive and is triggered by anxiety. People who suffer from trichotillomania have a hard time controlling the urge to pull out their hair.

When someone with trichotillomania pulls out their hair they feel relief. It eases feelings of frustration, anger hurt feelings, depression, anxiety and sadness. When experiencing these feelings, an affected person will pull hair from the head, eyebrows, eyelashes, face or other areas of the body.

A person with trichotillomania may or may not realize they are pulling out their hair. It is not uncommon for an affected person to pull out their hair unconsciously. They may or may not realize they are pulling out their hair until they see clumps in their hands or on the floor.

Signs of Trichotillomania

People with trichotillomania will show signs of pulling out their own hair. Signs that someone may be suffering from trichotillomania include:

  • Bald spots
  • Sores in affected areas
  • Excessive hair loss
  • Unconscious pulling hair, twisting hair or playing with hair when stressed
  • Finding clumps of hair in affected person’s living space
  • Wearing hats indoors
  • Chronic anxiety
  • Excessive worrying
  • Mood swings
  • Isolation or withdrawal from family and friends

Symptoms of Trichotillomania

Symptoms of trichotillomania typically surface between 9 and 11 years old. It is not uncommon for a condition to surface earlier or later in life.

People will pull out their hair in a response to any form of stress. People with trichotillomania also suffer from depression and/or anxiety. The act of pulling out their hair serves as a release of the tensions caused by these conditions.

Symptoms of trichotillomania include:

  • Difficulty handling stress or anxiety
  • Impulse control issues
  • Trouble resisting the urge to pull out hair
  • Unconsciously pulling out hair
  • Habit of inspecting, chewing or eating hair
  • Denial and shame about the behavior
  • Efforts to hide or conceal bald patches

Risk Factors of Trichotillomania

  • Suffering from another mental health disorder, like anxiety, OCD, depression, etc
  • Poor stress management skills
  • Poor adjustment to changing circumstances
  • Struggling to cope with life challenges
  • Family history of trichotillomania or anxiety disorders
  • Low self-esteem
  • Neglect, domestic violence or abuse
  • Trouble with expressing emotions in a healthy way

Treatment Options For Trichotillomania

The goal for treatment of trichotillomania is to learn healthy stress management skills. By learning healthy stress management skills, the affected person is less likely to pull their hair out.

Cognitive therapy is used to help a person learn healthy coping skills for stress. Cognitive therapy helps a person understand their thoughts an feelings. This helps identify and correct errors in thinking. Correcting errors in thinking lessens the intensity of negative feelings. Cognitive therapy also teaches healthy coping skills for stressful feelings and emotions.

Habit reversal training is also used to help treat trichotillomania. Habit reversal training helps an affected person be more aware of their behaviors. It also teaches them how to redirect their behaviors to something that is less self-destructive than pulling out their hair.

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