Trichotillomania (Hair-Pulling Disorder)

Trichotillomania (hair-pulling disorder) is characterized by recurrent pulling out of one’s hair resulting in hair loss, and repeated attempts to decrease or stop hair pulling. Hair pulling may occur from any region of the body in which hair grows; the most common sites are the scalp, eyebrows, and eyelids, while less common sites are axillary, facial, pubic, and peri-rectal regions(Christenson et al. 1991; Woods et al. 2006) Hair-pulling sites may vary over time. Hair pulling may occur in brief episodes scattered throughout the day or during less frequent but more sustained periods that can continue for hours, and such hair pulling may endure for months or years(Christenson et al. 1991; Woods et al. 2006).

The body-focused repetitive behaviors that characterize this disorder is not triggered by obsessions or preoccupations; however, they may be preceded or accompanied by various emotional states, such as feelings of anxiety or boredom. They may also be preceded by an increasing sense of tension or may lead to gratification, pleasure, or a sense of relief when the hair is pulled out.

Individuals who have trichotillomania may experience the following symptoms:

  • Recurrent pulling out of one’s own hair from any region of the body
  • Recurrent pulling out of hairs from pets, dolls, and other fibrous materials
  • Urge to pull hair from other individuals
  • Hair loss in varying degrees
  • Distress associated with the repetitive hair pulling (e.g. hiding action from others)

Trichotillomania is associated with distress as well as with social and occupational impairment(Woods et al. 2006). There may be irreversible damage to hair growth and hair quality. There are treatments for individuals who experience trichotillomania. If you suspect you may have trichotillomania, please mention this to your therapist and we can assess your symptoms and present treatment options to address your concerns.

Works Cited

American Psychiatric Association. (2013). Obsessive-Compulsive and Related Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.

Woods DW , Flessner CA , Franklin ME , et al: The Trichotillomania Impact Project (TIP): exploring phenomenology, functional impairment, and treatment utilization. J Clin Psychiatry 67(12):1877–1888, 2006

Christenson GA , Mackenzie TB , Mitchell JE : Characteristics of 60 adult chronic hair pullers. Am J Psychiatry 148(3):365–370, 1991

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