Trichotillomania: The Uncontrollable Urge to Pull One’s Hair

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Trichotillomania: The Uncontrollable Urge to Pull One’s Hair

Hair pulling disorder leads to noticeable hair loss / Photo by Ion Chiosea via 123RF


For some people, hair-pulling can be a form of stress-relief, while in others it can be a sign of frustration. A few individuals suffer from a condition wherein they have the impulsive tendency to keep pulling out hair from any part of their body. This disorder is called Trichotillomania (TTM) and is considered as an Impulse Control Disorder.

The consequences of this constant hair-pulling are hair loss and having bald spots, which may limit them in some aspects of their life. This may hinder their relationships or cause them to have a poor performance at work because of their embarrassment.

About 0.6% of people in the world suffer from this disorder. More men are affected by TTM than women. Approximately 80% to 90% of men have it, Trichotillomania Learning Center states.


Pulling hair disorder causes one to feel depressed, frustrated or ashamed / Photo by Chris Noble via 123RF


What Is Trichotillomania?

Houston OCD Program defines Trichotillomania (TTM) as the “recurrent pulling of one’s own hair, often  resulting in noticeable hair loss.” It is also known as the hair-pulling disorder.

Those who are affected by Trichotillomania usually pluck their eyelashes, eyebrows or hair from their scalp. They rarely pull the hair from their legs, chest, arms and pubic area. They may begin tugging at their hair whenever they feel relaxed or stressed. They may also keep doing it during a particular time or for a whole day.

Before pulling their hair, they may feel some tension or may feel an itch. If they fight against the urge to pull their hair, they may continue to feel that tension. Once they have pulled their hair, they may feel a sense of satisfaction, relief or pleasure. There are some people who pull hairs in wads, while there are also those who take them by strand. After pulling the hair, they may examine it or fiddle with it. It is said that half of the number of individuals who have Trichotillomania eat the hair which they pull out., explains.

People who suffer from this disorder may or may not be conscious of their hair-pulling habit. This may cause them to feel negative emotions such as being depressed, frustrated or ashamed. Since they feel worried about other people’s reaction to their condition, they may try to hide it. For instance, they may wear a hat to conceal their bald spot or make excuses about it.  Other people who may not fully know about Trichotillomania may think they are intentionally pulling their hair. For this reason, they may not even tell their family members about it.

Having this kind of Impulse Control Disorder may cause them to feel insecure about the way they look. They may also have trouble with finding a romantic partner or making friends. This can also result in self-blame or feeling helpless.


WebMD says that the exact cause for Trichotillomania cannot be pointed out. However, some possible factors are having a family member who suffers from the hair-pulling disorder, defects in the pathways of the brain that handle movement, emotion regulation, impulse control, and habit formation. This may also be possibly triggered by depression or anxiety.


According to the Mayo Clinic, patients who struggle with Trichotillomania may display these symptoms:

1. They may frequently pull their hair often from their scalp, or they may pluck their eyebrows, eyelashes, and hair from other regions of their body. Gradually, they may pull out hair from different locations.

2. They may also feel some sort of tingle before pulling or after trying to counter their desire to pull their hair.

3. When they are finally able to pull out hair, they feel relief or a pleasurable sensation.

4. They may favor certain kinds of hair and have patterns of pulling them

5. It is observable how they are slowly getting bald. Other people may see how they lack eyelashes or eyebrows or may notice how their hair has become shorter. They may also see bald spots or thinned areas.

6. They may bite, chew or eat their hair.

7. They may also rub the hair they pulled out on their face or play with it.

8. Even though they are trying to prevent themselves from pulling their hair, or try to lessen how often they do it, they keep failing.

They may also have the tendency to bite their nails, chew their lips or pick their skin. In some instances, they may also pull hairs from objects or animals. They may pluck hairs from pets, dolls, clothes or blankets. Oftentimes, they may only pull their hair when they are alone or where no one can see them.


Treatment approaches for Trichotillomania as suggested by Psycom include Habit Reversal, Cognitive Therapy (CT),  Self-awareness training, Deep breathing training, Process-Oriented Therapy, Family Therapy, and Group Therapy. Doctors may also prescribe anti-anxiety medication to them such as SNRIs and SSRIs.

If left unaddressed, this may lead to further complications such having hairballs in their digestive tract, skin damage, a loss of self-confidence and social and work problems.



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