What is trichotillomania?

What is trichotillomania?

Trichotillomania (TTM) is an impulse disorder. People who have this disorder pull out the hair from the scalp, eyelashes, eyebrows, or other parts of the body until they have bald patches.

What is the cause?

The cause of this disorder is not known. Experts think it may be caused by differences in the brain or nervous system. It might also be related to things such as child abuse or a family history of mental illness. It may be related to certain chemical messengers between the nerve cells in parts of the brain.

People often start compulsive hair-pulling around the ages of 12 or 13. It often seems to begin after a stressful event such as change of schools, abuse, family conflict, or the death of a parent.

What are the symptoms?

The symptoms of TTM include:

  • constant tugging and twisting of hair
  • repeatedly pulling enough hair over a long enough period of time to have bald spots on the head, or missing eyelashes, eyebrows, or other body hair
  • feeling very tense right before pulling out the hair or if they try to resist the urge to pull hair
  • feeling pleasure or relief when pulling out the hair
  • denying that they are pulling hair

People with TTM do not lose hair due to a skin or other medical condition. They pull hair on purpose.

How is it diagnosed?

A healthcare provider or a mental health professional will ask about symptoms and any drug or alcohol use. The person may have lab tests to rule out medical problems.

How is it treated?

Antidepressants and antianxiety medicines may reduce the urge to pull hair. Medicines may also help to reduce depression and obsessive-compulsive symptoms. Medicines may help, but symptoms are likely to return unless behavioral therapy is also a part of the treatment.

Cognitive behavioral therapy may help to manage anxiety or stress. In CBT, you identify the times of day, emotions, and other factors that trigger hair pulling. Then you learn to change how you respond to these triggers.

Consider attending a support group. Talking with other people who face the same challenges can help you cope with the TTM and its impact on your life.

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