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Treating Trichotillomania

treating trichotillomaAs a hair stylist with over 15 years of experience, I recently had the opportunity to work with a client who suffered from trichotillomania. Also called “hair pulling disorder,” trichotillomania is characterized by an obsessive pulling of one’s own hair, leading to hair loss and baldness. It’s often chronic, difficult to treat, and can lead to high stress and social impairment for the sufferer. The following is an account of our work with this client using my skills as a master stylist.

Our client had gone through years of hiding her pull spots and had become masterful at finding different up-styles to camouflage her problem areas. The idea was to add hair extensions, as the client and her behavioral therapist believed it would help her to stop her compulsive pulling.

At our initial consultation, I saw that the client suffered from a highly advanced case; 90 percent of her hair on both sides of her head below the crown had been pulled. What little remaining hair she had left was just 1/4 inch to 1/2 inch long.

My team and I set out to attach tape-in hair extensions. (We used Invisitab extensions from House of European Hair.) I worked out a technique that allowed us to attach these extensions to the very little hair the client had left. Due to the medical grade glue used to adhere the extensions together, this method was much less damaging and created far less tension on the client’s own hair than other methods of application, such as bonded/fused extensions. We knew she would have pulling episodes, so we reinforced those sites where she was likely to pull with additional extensions. In the hopes of regrowing all of her hair, we set a goal of two years for the full recovery of her natural hair.

She was ecstatic just after our first extension attachment. All at once, her confidence had dramatically improved. For the first time since she was 11 years old, she had a full head of hair. With the added incentive of protecting her investment, as each extension cost $150 to reattach, my client consciously resisted the urge to pull because she was so proud of how she looked. Extensions are expensive. Part of her therapy had to include this desire to preserve that investment.

Setting achievable goals also contributed to her success. She had a very big event coming up in eight months — her sister’s wedding — which made it imperative for her to look and feel as good as possible. Although she had some setbacks, once she started seeing progress she became more aware of her urge to pull, thus avoiding it altogether.

After two years, approximately five different sets of extensions, and with the use of a partial wig, we were successful in regrowing her natural hair. My client believes that her success was due to the collaboration of her hairstylist (myself), behavioral therapist, and medication prescribed by her psychologist (who treated her anxiety). She now lives with a full head of her own hair and is no longer suffering from trichotillomania.

Extensions helped her to look and feel beautiful again. She was no longer hiding her illness — she felt normal. This is an extreme example of how hair extensions can be utilized as part of a patient’s therapy to help regrow and maintain hair.

Woman pulling hair photo available from Shutterstock

Treating Trichotillomania

Donna Tripodi

Donna Tripodi is a master stylist at Eva Scrivo Salons in New York City.

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APA Reference
Tripodi, D. (2018). Treating Trichotillomania. Psych Central. Retrieved on August 9, 2020, from
Scientifically Reviewed
Last updated: 8 Jul 2018 (Originally: 19 Apr 2016)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
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