Trichotillomania is a mental illness in which individuals pull their hair out, creating noticeable bald or thin spots on their heads. People affected by Trichotillomania often feel distress and shame over their behavior.
Symptoms
Trichotillomania can be challenging to diagnose. We must distinguish it from medical conditions like Alopecia Areata that cause hair loss patches. Your physician will evaluate your symptoms and ask about any family histories of mental health concerns.
People living with Trichotillomania often report feeling embarrassed and ashamed of their behavior, hiding any hair loss with hats, scarves, or makeup to avoid social situations. Untreated Trichotillomania may cause noticeable bald spots over time.
People suffering from Trichotillomania often pull their hair hard, creating red marks on their scalp, or ripping it out at its roots, making red marks or tears in the hair strands. Others may eat their pulled locks (trichophagia), resulting in intestinal blockages, or create large matted wads called trichobezoars requiring surgical removal. Furthermore, people suffering from this disorder have other body-focused repetitive behaviors, including biting their nails, picking at skin, or playing with eyelashes – making life increasingly stressful and challenging.
Causes
People affected by Trichotillomania often feel an irresistible urge to pull their hair out, leading them to create patchy bald spots that impede everyday activities. Some attempt to cover them up using hair clips, scarves, or wigs, but some also experience anxiety or depression due to this disorder.
Trichotillomania can affect any area where hair grows, most commonly the scalp and eyelashes or eyebrows. Symptoms typically develop before or after puberty and often remain chronic, with symptoms waxing and waning over time; women are more prone to this disorder than men.
The causes of Trichotillomania remain unknown. As an impulse control disorder, those suffering from it know their behavior is harmful but cannot stop themselves. Like other impulse control disorders, Trichotillomania is believed to be caused by an imbalance in the brain’s reward system and can make controlling urges difficult, particularly during stress.
Treatment
Some ways can help those suffering from hair-pulling disorder reduce their symptoms, such as behavioral therapy and medication.
People suffering from Trichotillomania often don’t recognize how often they pull. At first glance, they may believe they are just temporarily bald or missing eyebrows or eyelashes. Still, their condition can have severe repercussions for both life and self-image – from social isolation due to hiding their habit to financial problems caused by missing work due to appearance issues.
Behavior therapy and medications have proven to be the most successful treatments for Trichotillomania. Behavior therapy includes various approaches, such as habit reversal training, which relies on how the brain forms habits; cognitive behavioral therapy includes learning new coping skills to address root causes of symptoms; while medications such as selective serotonin reuptake inhibitors (SSRIs and clomipramine) block the reuptake of serotonin.
Prevention
Early intervention can make all the difference. The first step should be speaking to a mental health provider with experience treating body-focused repetitive behaviors like Trichotillomania.
A clinician will assess if hair pulling is automatic or intentional. They’ll try to understand its source – is your child bored? Stressed? – before working together to find what’s known as a competing response that might replace hair-pulling behavior with something less destructive, like squeezing a ball or using other methods such as tapping.
Medication may also support by blocking certain neurotransmitters in the brain that trigger and reward behavior. Medication should only be taken under the guidance of a trained professional; serious side effects may result in their misuse. N-acetylcysteine (NAC), an all-natural health supplement, is also effective; however, any possible medical causes of behavior must be excluded first before beginning its use.
