Trichotillomania, the compulsion to tear off your hair

Trichotillomania, the compulsion to tear off your hair

People with trichotillomania feel an irresistible need to compulsively tear their hair, usually from the scalp, eyelashes and eyebrows, but it can be from different parts of the body.

Trichotillomania is a type of impulse control disorder. People with this type of problem know that they can hurt themselves by acting impulsively, but somehow they cannot stop. They usually tear their hair when they are anxious or stressed to try to calm down.


  • 1 Symptoms of Trichotillomania
  • 2 What causes Trichotillomania?
  • 3 What is the treatment for trichotillomania?

Symptoms of Trichotillomania

In addition to pulling your hair compulsively, there are other symptoms that may suffer:

  • Feeling anxious before pulling hair or trying to resist temptation.
  • Feel relief or satisfaction after pulling.
  • Problems at work or social life due to the anxiety this implies and the aspect they offer after tearing their hair.
  • Behaviors such as inspecting hair root, twisting hair, pulling hair with teeth or even eating hair.

Many people who have trichotillomania try deny the problem and can try to hide your hair loss wearing hats, scarves, false eyelashes or eyebrows.

What causes Trichotillomania?

The exact cause of trichotillomania is not known. However, we do know that there are several factors to consider. Certain personality traits such as low tolerance for stress, perfectionism and the tendency to suffer anxiety They are obvious. The way to process external stimuli is also relevant when discussing etiology. Although as in all other mental health disorders, there are always exceptions.

Neurobiological research using brain scans shows that the brain functioning of people with trichotillomania differ from healthy subjects, resembling those of people with attention deficit / hyperactivity disorder (ADHD) or with obsessive compulsive disorder (OCD). Even a genetic component has been described in some cases, identifying families in which trichotillomania was diagnosed in parents and children or siblings.

Risk factors therefore include family history; age (the peak of onset is usually between 11 and 13 years of age); the poor mechanisms of adaptation and emotional regulation; premorbid mental health diagnoses such as ADHD, OCD, tics disorder, eating disorder, anxiety disorder or depressive disorder.

What is the treatment for trichotillomania?

The main treatment for trichotillomania is a type of behavior modification behavior therapy, called habit reversal training. Basically, this means replacing a bad habit with something else that is not harmful.

With this approach, people with trichotillomania first they learn to identify when and where they need to pull hair. They also learn to relax and do something else, which doesn't hurt them, as a way to help relieve tension when they feel the need to pull their hair.

It could be as simple as clenching the fist with the hand they would use to get their hair out. Therapy can also address any distorted thinking that may be increasing the stress that triggers the behavior.

When trichotillomania manifests itself in adulthood, it may be associated with other psychological or psychiatric disorders, and consultation with a specialist is advisable, since the fact of tearing off the hair is usually resolved when the other conditions are treated.

Recognize behavior and increase awareness of the thoughts and feelings that the impulses produce, as well as understanding that the impulses are different from the behaviors, helps to break the usual cycle of pulling the hair, increasing the skills for positive coping, and incorporating methods of sensory self-regulation.


American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Editors of 4th ed. Washington DC: American Psychiatric Association; 1994

Damodaran SS, Jayalekshmi KT, Khanna R. Trichotillomania: symptom or syndrome. Need revision? Psychopathology. nineteen ninety five

Christenson GA, Mansueto CS. Trichotillomania: descriptive characteristics and phenomenology. In: Stein DJ, Christenson GA, Hollander E, editors. Trichotillomania Washington DC: American Psychiatric Press; 1999

Chamberlain, SR, Menzies, L., Sahakian, BJ, and Fineberg, NA (2007). Lifting the veil over trichotillomania. The American Journal Of Psychiatry, 164 (4), 568-574. doi: 10.1176 / appi.ajp.164.4.568

Stein DJ, Hollander E, Cohen L, Simeon D, Aronowitz B. Serotonergic receptivity in trichotillomania: neuroendrocrine effects of m-chlorophenylpiperazine. Psychiatry Biol. 1995