Trichotillomania (trik-o-til-o-MAY-nee-a) is a condition that involves compulsive (kom-PUL-siv) hair pulling, usually the hair on the scalp or the eyebrows or eyelashes.
Trichotillomania is a condition that involves strong urges to pull hair. People with this condition pluck or pull the hair on their heads, their eyelashes, their eyebrows, or hair on other body parts. For people with trichotillomania, the hair pulling is more than a habit. It is a compulsive behavior, which means the behavior is irrational and very hard to stop. A person with trichotillomania feels a strong urge to pull hair, an impulse that is so powerful that it seems impossible to resist.
Pulling the hair often provides a brief feeling of relief, like the feeling of finally scratching an itch but much more intense. But after the feeling of relief, which lasts only a moment, the person usually feels distressed and unhappy about having pulled the hair. Soon the urge to pull hair returns. People with trichotillomania wish they could stop, and they may feel ashamed or embarrassed. Many people who have this condition try to keep it secret.
The condition trichotillomania was first described in 1889 by the French physician François Hallopeau (1842–1919). The term “trichotillomania” comes from the Greek words thrix, meaning “hair,” and tillein, meaning “to pull.” Mania, the Greek word for “madness” or “frenzy,” was used in the 19th century for any condition that affected human behavior. Hallopeau wrote that his patients with hair-pulling compulsions were, in fact, quite emotionally healthy.
Although the exact cause of trichotillomania is unknown, by 2015 there was growing evidence that suggested it is a biological disorder of neurotransmitter * function in the brain. Trichotillomania has some similarities to obsessive-compulsive disorder * (OCD), but in trichotillomania, there are no obsessions * and hair pulling is the only compulsion. Both trichotillomania and OCD fall into the larger category of anxiety disorders * . Some people with trichotillomania have other forms of anxiety as well. Trichotillomania can affect children, adolescents, and adults. Both males and females can have trichotillomania, but it seems to be more common among females.
One common treatment for trichotillomania is a behavior therapy * technique called habit reversal. In habit reversal, the person first learns to notice the urge before the compulsion to pull hair becomes too strong to resist. Then the person learns to do something else instead of hair pulling until the urge grows weaker and passes. This shift in behavior can be more difficult than it sounds because the person may feel increasing, uncomfortable tension and anxiety while trying to resist the urge to pull hair. With time and practice, the brain can begin to react differently to the urges, and the person can start to control the compulsive behavior. Some people may also take medication that helps with the compulsions and decreases the strength of the urges, making them easier to resist. After a few weeks of practice, coaching from her therapist, and support from her parents, Penny began to get better at resisting the urges she felt. Penny started to see results; her hair began to grow back in.
Now that Penny's hair and eyebrows are growing in, she feels better about herself and more hopeful about coping with trichotillomania. Now and then, Penny continues to feel urges to pull her hair and eyebrows, but she knows what to do to resist them. She knows that these impulses can be stronger in times of stress, but they can also arise on their own during times when Penny is bored or just relaxed. Her therapist helped Penny learn and practice ways to cope with normal stresses, to stop the urges before they get too strong, and to control her compulsive pulling.
See also Anxiety and Anxiety Disorders: Overview • Obsessive-Compulsive Disorder
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Mouton-Odum, Suzanne, and Ruth Goldfinger Golomb. A Parent Guide to Hair Pulling Disorder: Effective Parenting Strategies for Children with Trichotillomania. Racine, WI: Goldum, 2013.
MedlinePlus. “Trichotillomania.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/001517.htm (accessed November 18, 2015).
American Academy of Child and Adolescent Psychiatry. 3615 Wisconsin Ave. NW, Washington, DC 20016-3007. Telephone: 202-966-7300. Website: http://www.aacap.org (accessed November 18, 2015).
Mental Health America. 2000 N. Beauregard St., 6th Fl., Alexandria, VA 22311. Toll-free: 800-969-6642. Website: http://www.mentalhealthamerica.net (accessed November 18, 2015).
Trichotillomania Learning Center. 207 McPherson St., Ste. H, Santa Cruz, CA 95060-5863. Telephone: 831-457-1004. Website: http://www.trich.org (accessed November 18, 2015).
* neurotransmitter (NUR-o-tranzmit-er) is a brain chemical that lets brain cells communicate with each other and therefore allows the brain to function properly. In other words, a neurotransmitter transmits (carries) a chemical message from neuron to neuron.
* obsessive-compulsive disorder is a condition that causes people to become trapped in a pattern of repeated, unwanted thoughts, called obsessions (ob-SESH-unz), and a pattern of repetitive behaviors, called compulsions (kom-PUL-shunz).
* obsessions (ob-SESH-unz) are repeated disturbing thoughts or urges that a person cannot ignore and that will not go away.
* anxiety disorders (ang-ZY-etee dis-OR-derz) are a group of conditions that cause people to feel extreme fear or worry that sometimes is accompanied by symptoms such as dizziness, chest pain, or difficulty sleeping or concentrating.
* ringworm is a fungal infection of the skin or scalp that appears as a round, red rash.
* alopecia areata (al-o-PEA-shah a-ree-AH-ta) is a condition that leads to sudden hair loss, often in small, round patches on the scalp. The cause is not known.
* behavior therapy is a type of counseling that works to help people change their actions.