Hair-Pulling Disorder

People with Trichotillomania may pull hair from their scalps, eyebrows, eyelashes or other parts of their body.

People with Trichotillomania may pull hair from their scalps, eyebrows, eyelashes or other parts of their body.

According the Mayo Clinic, Trichotillomania, also called hair-pulling disorder, is a behavioral difficulty that involves recurrent, strong urges to pull out hair from your scalp, eyebrows or other areas of your body, despite trying to stop.

For some people, it is a mild, manageable behavior. For others, it is an overwhleming compulsion that leaves them with bald spots and scabby patches that they go through great lengths to hide, causing acute embarrassment and shame. Trichotillomania can lead to personal distress, including problems at work, school and other social situations.

Often, trichotillomania first appears in childhood. In preschool children, both boys and girls are affected equally, whereas 70-93% of preadolescents and young adults with the disorder are female. Among adults, the prevalence among women versus men is even higher.

Identifying and treating the disorder as soon as possible is important. Trichotillomania responds best to early intervention — the longer it is left alone, the poorer the prognosis. The sign and symptoms of the disorder include (adapted from mayoclinic.org):

  • Repeatedly pulling your hair out, typically from your scalp, eyebrows or eyelashes, but sometimes from other body areas, and the sites may vary over time
  • An increasing sense of tension and anxiety before pulling, or when you try to resist pulling
  • A sense of pleasure or relief after the hair is pulled
  • Noticeable hair loss, such as shortened hair or thinned or bald areas on the scalp or other areas of your body, including sparse or missing eyelashes or eyebrows
  • Preference for specific types of hair, rituals that accompany hair pulling or patterns of hair pulling
  • Biting, chewing or eating pulled-out hair
  • Playing with pulled-out hair or rubbing it across your lips or face
  • Repeatedly trying to stop pulling out your hair or trying to do it less often without success

There are two types of hair pulling:

  • Automatic. Some people pull their hair without even realizing they're doing it, such as when they're bored, reading or watching TV. About 75% of adults with the disorder engage in this type of hair pulling.
  • Focused. Some people intentionally pull their hair to relieve tension or distress — for example, pulling hair out to get relief from the overwhelming urge to pull hair. Some people may develop elaborate rituals for pulling hair, such as finding just the right hair or biting pulled hairs. People with focused pulling are also more likely to engage in additional repetitive behaviors such as skin picking.

If you or someone you know compulsively pulls out their hair, contact the BFDC. Over half of individuals with trichotillomania also suffer from another disorder, such as depression, anxiety, phobias, OCD and more. We can help.