The compulsive pulling of one’s own scalp or body hair. Sometimes it is moderately manageable, but other victims find the compulsion to pull out their hair completely uncontrollable and thus devastating to their lives.

Trichotillomania is believed to fall somewhere within the obsessive-compulsive spectrum. It appears more often among the relatives of people with obsessive compulsive disorder (OCD) and tic disorders than in the general population.

Many people with trichotillomania describe an increasing sense of tension before pulling the hair followed by a feeling of gratification or relief after pulling. For many, the urge is described as overwhelming which leads to continuous hair pulling despite desperately wanting to stop. Others, however, appear to pull out their hair in a “trance-like” state. In this case, it is more of a mindless habit rather than the giving in to a relentless urge. Experts have, therefore, divided the disorder into “focused” and “automatic” subtypes.

Very young children often fall into the automatic subtype, while older individuals may have a more focused, or conscious, ritual of hair pulling. This may include searching for the hair that feels “just right” which leads to the feeling of gratification.

The scalp is the target of most hair pulling, followed by eyelashes and eyebrows and then other types of body hair, such as beards, chest hair, arm or leg hair, and pubic and underarm areas.

Trichotillomania typically emerges between the ages of 9 and 13, although it can begin well before or after this age range and last throughout adulthood. Trichotillomania is estimated to affect somewhere between 0.6% to 4% of the population. It is difficult to gauge, however, as experts believe the disorder is significantly underreported.

Habit reversal training (HRT), a type of cognitive behavioral therapy (CBT), is the most preferred and effective treatment for trichotillomania. During HRT, the individual learns to consciously recognize and label the hair pulling sensation and to redirect this impulse.

Example: A physician notices a peculiar pattern of hair loss, which the patient admits was caused by her habit of pulling at her hair.

This link is to the Trichotillomania Learning Center: