Understanding Trichotillomania (TTM): Causes, Symptoms, and Management

What is it?

Trichotillomania, also called hair-pulling disorder, is a mental disorder that involves persistent, powerful urges to pull out one's hair, eyebrows or other areas of your body. As the hair is removed, the person might feel good for some time. The person fails to stop pulling his hair, even though he wants. This behavior can result in areas with hair loss and causes serious distress and can affect one's social and work functioning. The disorder occurs more in people with obsessive compulsive disorder (OCD).

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Additional names

This group contains additional names:
- Hair Pulling Disorder
- Compulsive Hair Pulling

Signs & symptoms

symptoms may include: Repeatedly pulling hair out, typically from scalp, eyebrows or eyelashes, or any other body part. Sites may vary over time.
Feeling anxious before pulling, or when trying not to pull.
Positive sensation such as relief after the hair is pulled.
Failed trials to stop hair pulling.
Bald, thinned or shorter hair in the area of pulling.
Biting, chewing or eating pulled-out hair
Playing with pulled-out hair
Distress or problems at work, school or in social situations due to the hair pulling.

Diagnosis

diagnosis according to DSM-5: A. Recurrent pulling out of one’s hair, resulting in hair loss. B. Repeated attempts to decrease or stop hair pulling. C. The hair pulling cannot be better explained by the symptoms of another mental disorder (e.g., attempts to improve a perceived defect or flaw in appearance, such as may be observed in body dysmorphic disorder). D. The hair pulling or hair loss cannot be attributed to another medical condition (e.g., a dermatological condition). E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Treatment

Treatment includes psychotherapy and medication. The most beneficial psychotherapy treatment for trichotillomania is Habit reversal training (HRT), with or without medication combined. In HRT, the patient learns to recognize the impulse ant to react to it. Other methods of treatment include biofeedback, hypnosis and Acceptance and commitment therapy (ACT). Although the FDA has not approved any medication for trichotillomania, treatment includes antidepressants such as clomipramine (Anafranil), N-acetylcysteine and antipsychotic drug like Zyprexa.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital