A distressed reader recently reached out with the message above, expressing real worry. We appreciate his bravery in seeking help.
But is this behavior of hair-pulling an isolated incident, or is it a condition?
Readers, twisting and pulling out hair until it’s removed is a real disorder, and those affected often cannot stop this behavior on their own. It’s called trichotillomania, an emotionally and physically painful condition.
According to our research, this disorder was once believed to primarily affect women. However, with the rise of mass communication—satellite TV, health channels, hair blogs, social media, and the internet—men are now more aware that they too experience this issue and are seeking help. This shows that trichotillomania isn’t limited by gender; it affects humanity as a whole.
We’re glad our readers feel comfortable sharing their concerns with us on this hair health blog, and we’re here to help identify ways to improve well-being, offering guidance for maintaining both health and hair.
What Triggers Trichotillomania?
Emotions are the primary trigger for trichotillomania—our minds are powerful, and this disorder often stems from negative emotions in the brain. Pulling hair is a way to cope with these emotions, such as stress, anxiety, tension, boredom, loneliness, extreme fatigue, or frustration. Ironically, this loss of control can lead to visible hair loss, which then adds to the person’s distress. Seeing bald spots appear in social settings can further affect their self-image, impacting their social, work, and personal life.
Understanding your mind and identifying negative feelings is essential to finding healthier ways to manage them.
Types of Trichotillomania
Although trichotillomania can be classified in various ways, we find it helpful to categorize it by the person’s level of awareness when pulling their hair:
1. Automatic: The person is unaware of the hair-pulling, as it often happens while they’re focused on other activities, such as studying, watching TV, or talking on the phone. This type accounts for 75% of trichotillomania cases.
2. Focused: The person is fully aware of their actions but feels unable to resist the urge to pull. Tension builds up, which subsides once they pull out hair. This applies to 25% of cases.
Most people experience both types at different times.
Note: This information does not replace a consultation or diagnosis from a medical professional.
Trichotillomania Treatment
- Cognitive-Behavioral Therapy (CBT): Often focused on habit reversal training
- Medications: Selective serotonin reuptake inhibitors (SSRIs) or clomipramine
- N-Acetylcysteine or Memantine: Glutamate modulators
- Family and Support Therapy
- Visual and Physical Hair and Scalp Examinations
- Scalp Microscopy
- Scalp Biopsy
How Can Trichotillomania Be Treated?
Cognitive-behavioral therapy (CBT) is considered the primary treatment for trichotillomania. This therapy helps individuals become more aware of their actions, recognize their triggers, and develop strategies to replace hair-pulling with alternative actions, such as clenching fists, sitting on hands, or redirecting their hands toward their ear instead of their hair.
Complications from Trichotillomania
Complications can include rashes or erythema in the affected area, alopecia, scalp infections, and even carpal tunnel syndrome. In severe cases, some people ingest the pulled hair, which can lead to the formation of trichobezoars (hairballs) in the digestive tract, causing intestinal blockages with potentially serious consequences. Using Melanobars can help maintain the scalp health.
When to See a Doctor
If you can’t stop pulling your hair and feel self-conscious about your appearance, it’s time to speak with a doctor. Trichotillomania is not simply a bad habit; it is a mental health condition, and it’s unlikely to improve without treatment.
Important Information
Through this blog, I hope to raise awareness of various behaviors that affect both health and hair. While trichotillomania is relatively uncommon, it’s essential to recognize its symptoms. If you notice these signs in yourself, please consult a doctor immediately.
