Trichotillomania

Overview:

Trichotillomania is an impulse control disorder which causes people to pull out their hair. Trichotillomania can cause patchy hair loss on the scalp, eyebrows, eyelashes, and other areas of the body. The cause of trichotillomania is unknown, but it is thought to be related to problems with the nervous system. Trichotillomania is diagnosed by a dermatologist based on a history and physical examination. Treatment for trichotillomania often involves a team approach between a psychiatrist or neurologist and a dermatologist. Prognosis for trichotillomania varies depending on the severity of the condition.

Cause:

Trichotillomania is an irresistible urge to pull out one's hair. It is a disorder that results from problems with the nervous system. The exact cause of trichotillomania is unknown, but it is believed to be linked to anxiety or other underlying emotional issues.

Symptoms:

The primary symptom of trichotillomania is the repeated urge to pull out one's hair. This can result in patchy hair loss and bald spots. Other symptoms may include:

• Compulsion to pull hair

• Difficulty concentrating

• Anxiety or stress

trichotillomania hair pulling

Source: https://commons.wikimedia.org/wiki/File:Tricotillomania.png

License: Giacomo Ritucci, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons

Diagnosis

Trichotillomania is usually diagnosed by a dermatologist. The diagnosis is based on a history and physical examination. A biopsy may be necessary to rule out other causes of alopecia such as alopecia areata.

Treatment

Treatment for trichotillomania is often multidisciplinary between a psychiatrist or neurologist and a dermatologist. Treatment options may include:

• Medications designed to modulate the nervous system

• Psychotherapy

• Behavior modification

Prognosis

The prognosis for trichotillomania is variable. With treatment, many people are able to control their urges and stop pulling out their hair. While hair loss is reversible if treated early, in advanced stages hair follicles can scar and loss may be permanent.

References:

1. National Institute of Mental Health. Trichotillomania. Accessed March 9, 2021. https://www.nimh.nih.gov/health/topics/trichotillomania/index.shtml

2. Mayo Clinic Staff. Trichotillomania (hair-pulling disorder). Accessed March 9, 2021. https://www.mayoclinic.org/diseases-conditions/trichotillomania/symptoms-causes/syc-20353552

3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: DSM-5.

 FAQs

  • There is no cure for trichotillomania, but it is a treatable condition. With treatment, many people are able to control their urges and stop pulling out their hair.

  • The long-term effects of trichotillomania depend on the severity of the condition. In mild cases, hair loss is typically reversible with treatment. However, in advanced cases, hair follicles can scar and loss may be permeant.