Trichotillomania 1675 1153 Paterakis Michalis
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What is Trichotillomania?

Trichotillomania is a disorder characterized by the pulling of hair from various parts of the body and affects many people worldwide. It can have a significant impact on a person’s mental health and overall quality of life.

Despite being recognized as a distinct disorder, trichotillomania remains largely unknown to the general public.

However, with the right treatment and appropriate coping strategies, it is possible to manage and overcome trichotillomania. In this article, our goal is to provide a comprehensive overview of trichotillomania, its symptoms, causes, and treatment options to help understand and promote recovery.

Understanding trichotillomania

Trichotillomania, a disorder characterized by repetitive hair pulling resulting in noticeable hair loss, is associated with a range of symptoms including tension, anxiety and the pleasure of pulling hair. Pulling is not limited to the scalp, but can also involve other parts of the body, such as the eyelashes, eyebrows, pubic hair, hands, feet, and armpits. This disorder can vary in frequency, intensity and duration.

Symptoms of trichotillomania can be both physical and emotional. Physical symptoms can include hair loss, bald spots, and broken or damaged hair follicles. Emotional symptoms may include feelings of shame, guilt, and embarrassment. It is often accompanied by other psychiatric disorders such as anxiety and depression, and may also coexist with other body-focused repetitive behaviors such as skin picking and nail biting.

Although the exact cause of trichotillomania is unknown, it is believed to be a combination of genetic, environmental and psychological factors.

Treatment may include a combination of medication, therapy, and support groups. Cognitive-behavioral therapy is an effective treatment for trichotillomania because it helps people identify and modify the thoughts, feelings, and behaviors that contribute to hair pulling.

With appropriate treatment, individuals are able to manage their symptoms and improve their quality of life.

The prevalence and impact of trichotillomania

The compulsive behavior of hair pulling disorder affects approximately 1-2% of the population, with women more commonly affected than men. This condition is often misunderstood, as a result of which it has a significant impact on the lives of those who suffer from it. Trichotillomania can cause physical and emotional harm, including hair loss, physical injuries and social isolation.

It can also occur at any age, but often begins during adolescence or early adulthood. It is classified as obsessive compulsive disorder and is often accompanied by depression, anxiety and other mental health conditions. The impact of trichotillomania can be significant, affecting daily functioning and quality of life.

People with trichotillomania may experience shame and embarrassment, causing them to avoid social situations and have difficulty forming relationships. The condition can also affect work or school performance.

Seeking professional help and support from others can significantly improve prognosis and help sufferers manage the effects of this complex disorder.

Possible causes of trichotillomania

Research suggests that possible causes of trichotillomania may include genetic predisposition, neurobiological abnormalities, and environmental stressors.

Studies have shown that people with trichotillomania often have family members with the disorder or other related conditions, such as obsessive-compulsive disorder or Tourette syndrome. This suggests that there may be a hereditary component to the disorder.

Neurobiological abnormalities also appear to play a role in its development. Research has shown that people with the disorder show changes in brain function and structure, especially in areas related to impulse control and reward processing. This suggests that there may be a malfunction in the brain’s reward system, leading to the compulsive behavior of hair pulling.

Environmental stressors, such as trauma or other life events, have also been identified as possible causes for trichotillomania. Stressful experiences can trigger or worsen the disorder, as individuals may turn to hair pulling as a coping mechanism. In addition, environmental factors may interact with genetic and neurobiological factors and increase the risk of developing this disorder.

Diagnosis of trichotillomania

A diagnosis of trichotillomania requires professional evaluation and assessment to distinguish it from other conditions with similar symptoms. It is not uncommon for people with trichotillomania to be misdiagnosed with conditions such as obsessive-compulsive disorder, anxiety, or depression. This is because these conditions may also involve compulsive or repetitive behaviors. However, trichotillomania is a separate disorder and requires specific treatment.

To receive a proper diagnosis, individuals should seek professional help from a mental health provider experienced in treating trichotillomania. This may include a clinical psychologist, psychiatrist, or licensed therapist. He will conduct a thorough assessment that may include an interview, self-report measures, and observation of hair pulling behavior. In addition, he may ask about family history and any other medical or psychological conditions that may be present.

Early diagnosis and treatment can lead to better outcomes. Treatment may include a combination of medication, therapy, and lifestyle changes. With the right support, people with trichotillomania can manage their symptoms and improve their quality of life.

Cognitive behavioral therapy

An effective treatment for trichotillomania involves using cognitive behavioral therapy techniques to address the underlying thoughts and behaviors. This type of therapy aims to identify and modify the negative thought patterns and behaviors that contribute to the urge to pull one’s hair. Treatment may include identifying triggers and learning coping mechanisms to manage the urge to pull hair, as well as addressing underlying emotional and psychological issues that may be contributing to the behavior.

Overall, cognitive behavioral therapy can be a useful tool for treating trichotillomania. By addressing the underlying thoughts and behaviors, individuals can learn to manage the urge to pull their hair and reduce the negative impact this behavior has on their lives. It is important to seek professional help from a trained therapist who specializes in the treatment of trichotillomania to ensure the best possible outcome.

Treatment and management strategies for trichotillomania

Coping strategies can be effective in managing the symptoms of compulsive hair pulling disorder. These strategies aim to reduce stress and anxiety, which often trigger the urge to pull out one’s hair.

One of the most effective self-help techniques is awareness training, which involves identifying the situations or emotions that trigger the urge to pull one’s hair. Once triggers are identified, the person can develop alternative behaviors such as deep breathing, relaxation exercises, and distraction techniques.

Another effective self-help technique is habit reversal training, which involves identifying the specific hair-pulling behavior and developing an antagonistic response. For example, if a person pulls their hair with their fingers, they can replace this behavior with squeezing a stress ball or fidget toy.

Additionally, engaging in activities that provide a sense of satisfaction and fulfillment can also reduce cravings. These activities may include exercise, creative activities and socializing.

Coping strategies such as positive self-talk, mindfulness, and self-compassion can help individuals manage the emotional distress associated with hair pulling disorder. Positive self-talk involves using positive affirmations and statements to counter negative thoughts and feelings. Mindfulness involves being aware of one’s thoughts, feelings, and bodily sensations without judgment, which can help reduce stress and anxiety. Self-compassion involves treating ourselves with kindness and understanding, which can help reduce feelings of shame and guilt.

By adopting these coping strategies and self-help techniques, people with trichotillomania can effectively manage their symptoms and improve their quality of life.

Frequent questions

What are some common triggers of trichotillomania?

Common triggers of trichotillomania include anxiety, stress, and perfectionism. Individuals may also engage in hair pulling as a coping mechanism for negative emotions or to relieve tension. Understanding these factors can help develop effective treatment strategies.

Can trichotillomania be completely cured or is it a lifelong disorder?

Trichotillomania is a chronic disorder characterized by repetitive hair pulling. While there are treatments available to manage the symptoms, there is currently no known cure. Continued research is needed to better understand the underlying causes of the disorder.

How does trichotillomania affect relationships and social interactions?

Trichotillomania can lead to strained relationships and social isolation due to the shame and embarrassment of pulling hair. However, seeking treatment and family support can help improve social and emotional functioning.

Can hair pulling cause permanent damage to the scalp or hair follicles?

Hair pulling or trichotillomania can cause permanent damage to the scalp and hair follicles, leading to gaps and thinning hair. Seek medical attention if you experience hair loss due to compulsive hair pulling.

Are there natural or alternative treatments for trichotillomania?

Natural or alternative treatments for compulsive hair pulling disorder are limited, but may include cognitive behavioral therapy and mindfulness practices.


Trichotillomania, also known as hair pulling disorder, is a serious mental health condition that affects millions of people worldwide. Despite its prevalence and impact, this disorder remains widely misunderstood.

Although  can be a difficult condition to manage, there is hope for recovery. Seeking professional help through therapy can be a critical first step in managing symptoms and improving quality of life.

In addition, self-help techniques such as mindfulness, stress reduction, and habit reversal training can be effective in reducing hair-pulling behavior. With the right tools and resources, people can overcome this disorder and live fulfilling lives.


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    Πατεράκης Μιχάλης
    Ψυχολόγος Αθήνα


      Psychologist Athens