Trichotillomania – Symptoms and Treatment
The defining characteristic of Trichotillomania is the recurrent, compulsive pulling out of one’s own hair, often resulting in observable hair loss. Usually, but not always, the scalp and/or face are the primary locations for hair pulling. While the most common hair pulling sites are the scalp, eyebrows, and eyelashes, Trichotillomania may involve any part of the body with hair. Less common locations for hair pulling include the pubic area, perirectal region, arms, chest, and legs. An individual with Trichotillomania may use his or her fingernails, as well as tweezers, pins or other mechanical devices. In severe cases, Trichotillomania can result in permanent hair loss or skin damage.
Often, but not always, Trichotillomania episodes are preceded by a high level of tension and a strong “urge.” Likewise, hair pulling is usually, but not always, followed by a sensation of relief or pleasure. Hair pulling is usually done alone, often while watching TV, reading, talking on the phone, driving or while grooming in the bathroom. A Trichotillomania episode may be triggered by a negative mood state or occur in response to stress but may also occur while an individual is calm and relaxed. Sometimes hair pulling is done as a conscious behavior, but it is frequently done as an unconscious habit. Recent reports indicate that approximately 10% of those with Trichotillomania also eat their hair after they pull it (Trichophagia). This can result in hairballs called bezoars, which can lead to severe gastrointestinal blockage.
Individuals with Trichotillomania often attempt to camouflage the hair loss that accompanies the disorder. Common camouflaging techniques include the use of hats, scarves, long-sleeve shirts, and false eyelashes. Some with Trichotillomania may even resort to having false eyebrows permanently tattooed. In extreme cases, individuals with Trichotillomania may avoid social situations in an effort to prevent others from seeing the hair loss that results from hair pulling.
