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Compulsive Hair Pulling: Understanding and Treating Trichotillomania

Barry can feel the tension building, sometimes for hours, before he yields to his impulse. Although he knows he’s affecting his dark good looks, the anxious feeling doesn’t fade until he’s yanked out another fistful of his own curly black hair. He immediately vows he’ll never do it again, but will readily admit he probably won’t be able to keep that promise.

For Belinda, the tension reliever is pulling out her now-stubby eyelashes. One at a time, slowly, ritualistically she removes the remaining hairs that line her upper and lower lids. She began removing them this way as a child, although she can’t recall exactly why or when. Despite numerous medical exams — first by her pediatrician and later by her internist and a dermatologist — no physical problems have been found. Her upper and lower eyelids are the only sign of this persistent habit. They have scarcely any hairs at all.

Louisa also tugs at her hair, pulling out a single strand at a time, dozens of times each day. Then she places the strands she’s removed from her scalp into her mouth. She’s seldom seen without a scarf that covers the bald spots this practice has created, but she denies that the patchy appearance of her hair is the result of her own behavior.

Barry, Belinda and Louisa all exhibit the classic symptoms of trichotillomania (pronounced trick-o-till-o-mania), a psychological disorder characterized by an inability to resist the impulse to pull out your hair. Frustrating to those who have it, their family members, and their doctors, the condition often begins in childhood, but can persist for decades — sometimes for a lifetime.

But despite the apparent oddity of their hair-related behaviors, the three are not alone.

Millions of Hair Pullers

Before impulse control disorders were widely recognized and understood, trichotillomania was believed to be a rare condition, but that’s no longer the case. The Trichotillomania Learning Center, Inc. (TLC), in Santa Cruz, Calif., provides support to people like Louisa, Barry and Belinda. Since 1991, the organization has responded to some 50,000 requests for information on the disorder from individuals with the condition, their family members and health professionals.

According to TLC, although there have been no scientific studies to identify the exact number of people with this condition, it is estimated that in the United States alone, there are probably between 6 to 8 million sufferers of trichotillomania. A survey of college students in the mid-1990s confirmed this estimate — almost two percent of students reported past or current problems with the impulse to pull out their hair.

Compulsive Hair Pulling: Understanding and Treating Trichotillomania

Holly VanScoy, Ph.D

APA Reference
VanScoy, H. (2020). Compulsive Hair Pulling: Understanding and Treating Trichotillomania. Psych Central. Retrieved on August 12, 2020, from
Scientifically Reviewed
Last updated: 14 Jan 2020 (Originally: 17 May 2016)
Last reviewed: By a member of our scientific advisory board on 14 Jan 2020
Published on Psych All rights reserved.