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

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Trichotillomania (TTM)

by Alike Medical Team ∙ Updated on June 13, 2023

Additional names

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

General

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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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.

Note

☝ We provide information on prescription and over-the-counter medicines, diagnosis, procedures and lab tests. This material is provided for educational purposes only and is not medical advice, diagnosis or treatment.

National Institutes of Health ∙ World Health Organization ∙ MedlinePluse ∙ Centers for Disease Control and Prevention

☝ All information has been reviewed by certified physicians from Alike

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