Trichotillomania - A maniacal disorder!

  • By Dr. T Deepa Porkodi

What is trichotillomania?

Trichotillomania, a hair-pulling disorder, is a mental disorder that involves an irresistible urge to pull out hair. This behavior occurs to the point of noticeable hair loss. The most common areas for hair pulling are the scalp, eyelashes, and eyebrows but may involve hair anywhere on the body.

Is it a mental disorder?

Yes. Trichotillomania is a type of impulse control disorder. Impulse control disorders are mental illnesses that involve the repeated failure to resist impulses, or urges, to act in ways that are dangerous or harmful. People with these disorders know that they can hurt themselves or others by acting on the impulses, but they cannot stop themselves.

Who suffers from trichotillomania?

It can affect all ages. In children both sexes are equally affected. In adults, women are more prone to it than men.

What causes trichotillomania?

The exact cause is not known. Researchers are exploring a possible link between trichotillomania and certain neurotransmitters. Most people who suffer from trichotillomania also suffer from anxiety and depression. There could be a cause-effect relationship between these diseases.

What are the symptoms of trichotillomania?

A person with trichotillomania cannot control or resist the urge to pull out his or her body hair. Other symptoms that might occur with this disorder include:

  1. A sense of tension before pulling hair or when trying to resist the urge to pull hair
  2. A feeling of relief, satisfaction, and/or pleasure after acting on the impulse to pull hair
  3. Presence of bare patches where the hair has been pulled out
  4. Presence of other associated behaviors such as inspecting the hair root, twirling the hair, pulling the hair between the teeth, chewing on the hair, or eating hair (called trichophagia)

Many people who have trichotillomania try to deny they have a problem and may attempt to hide their hair loss by wearing hats, scarves, and false eyelashes and eyebrows.

How is trichotillomania treated?

Behavioral Therapy i.e. Habit Reversal Therapy is the mode of treatment. Here the person is taught to first identify when and where the urge to pull out hair comes and then is is taught techniques for re-direction of the energy.
Medications used are generally antidepressants.

Does trichotillomania get cured completely?

It depends on the severity of the disease. Children recover faster. In adults though, the situation is chronic and much harder to treat.

What are the complications of trichotillomania?

Most people with trichotillomania also end up eating or swallowing their hair. This leads to formation of small hair-balls in their intestines that causes pain, nausea, blockage and other serious gastrointestinal problems.


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