Is Hair Pulling Just a Habit or Something More? Explore Trichotillomania!

Man pilling hair hair - Mental Disorder

Imagine waking up every day with an uncontrollable urge to pull  hair, leading to visible bald spots and deep emotional distress. This is the challenging reality for those living with trichotillomania, a mental health disorder often shrouded in silence and misunderstanding. Affecting approximately 3.5 percent of the U.S. population—an estimated 5 to 10 million Americans—this condition typically begins around puberty, bringing with it significant distress and impairment. With such a widespread impact, it’s crucial to shine a light on the causes, symptoms and treatments of this often misunderstood disorder. Let’s explore the intricacies of trichotillomania and how to   reclaim control over a healthy life.

Types Of Trichotillomania

Trichotillomania sometimes goes unnoticed. For instance, noticing hair on the couch while casually sitting on the couch, watching TV.  This behavior is known as automatic trichotillomania.

On the other hand, some pull their hair because it gives them a sense of pleasure. They often prefer to do this in solitude and may be particularly fixated on a specific type of hair. This behavior is referred to as focused trichotillomania.

Causes of Trichotillomania

The exact cause of trichotillomania is not fully understood, but it is believed to result from a combination of genetic, environmental, and psychological factors:

  • Genetic Predisposition: A family history of trichotillomania or other mental health disorders increase the risk.
  • Gender: Clinical sample reveals about 80 to 90% of adults with trichotillomania are female, suggesting that gender also influences the development and manifestation of the disorder.
  • Brain Chemistry: Imbalances in brain chemicals, such as serotonin and dopamine, play a role.
  • Stress and Anxiety: High levels of stress or anxiety triggers or exacerbate hair-pulling behaviors.
  • Environmental Triggers: Specific situations or sensory triggers precipitate hair-pulling episodes. This behavior often begins around puberty, a time of significant emotional and hormonal changes.

Symptoms of Trichotillomania

Trichotillomania manifests through a variety of symptoms that vary in severity in different cases. Key symptoms include:

  • Compulsive Hair Pulling: Recurrent, irresistible urges to pull out hair from the scalp, eyebrows, eyelashes, or other parts of the body.
  • Noticeable Hair Loss: Development of visible bald spots or thinning hair due to frequent pulling.
  • Tension and Relief Cycle: A sense of tension or anxiety before pulling, followed by relief or satisfaction afterward.
  • Failed Attempts to Stop:: Repeated but unsuccessful efforts to decrease or stop hair pulling.
  • Associated Behaviors: Some individuals may engage in rituals related to hair pulling, such as examining or playing with the pulled hair.
  • Psychosocial Dysfunction: The condition is frequently associated with low self-esteem and social anxiety, stemming from the visible effects of hair pulling and the inability to control the behavior.

Complications of Trichotillomania

Aside from the emotional burden and potential feelings of shame, trichotillomania leads to several other complications such as persistent work-related problems leading them to shy away from social gatherings, which significantly impact their personal and professional lives. The embarrassment associated with the disorder often leads to declining new job offers or promotions. Additionally, the physical act of hair pulling causes skin and hair damage, resulting in scars that affect hair growth. In severe cases, if individuals engage in Trichophagia, a related behavior where they eat the hair pulled out, occurs in over 20% of patients. This leads to serious complications such as gastrointestinal obstructions and trichobezoars (intestinal hairballs), which sometimes leads to weight loss, vomiting requiring surgical intervention or in extreme cases, can be fatal.

Treatment of Trichotillomania

Effective treatment for trichotillomania typically involves a combination of behavioral therapies, medication, and supportive interventions:

Cognitive Behavioral Therapy (CBT) is the cornerstone of treatment for trichotillomania. This form of therapy focuses on identifying and changing the thoughts and behaviors that lead to hair-pulling. Within CBT, Habit Reversal Training (HRT) is particularly effective. HRT involves several key components:

  1. Awareness Training: Helping individuals become more aware of their hair-pulling behaviors and the situations or emotions that trigger them.
  2. Competing Response Training: Teaching individuals to perform a different, less harmful behavior when they feel the urge to pull hair.
  3. Stimulus Control: Modifying the environment to reduce triggers and access to hair-pulling opportunities.
  4. Relaxation Techniques: Incorporating strategies to reduce stress and anxiety, which contribute to hair-pulling urges.

Support Groups

Joining a support group provides significant benefits for individuals with trichotillomania. These groups offer:

  1. Community and Connection: Feeling less isolated by connecting with others who understand their experiences.
  2. Shared Experiences: Learning from other’s  strategies and successes in managing the disorder.
  3. Emotional Support: Receiving encouragement and understanding from peers facing similar challenges.

Mindfulness and Stress Management

Incorporating mindfulness and stress management techniques is highly beneficial in reducing hair-pulling urges. These methods include:

  1. Mindfulness Meditation: Practicing mindfulness helps individuals stay present and aware of their thoughts and urges without acting on them. Techniques such as deep breathing and body scanning are particularly useful.
  2. Relaxation Exercises: Activities like progressive muscle relaxation, yoga, and tai chi  help reduce overall stress levels.
  3. Stress Management Strategies: Developing healthy ways to cope with stress such as enjoying nature, engaging in hobbies, exercising, or seeking social support, decrease the frequency and intensity of hair-pulling episodes.


While no medications are specifically approved for trichotillomania, certain drugs can help manage symptoms, particularly if anxiety or depression coexists. These include:

  1. Selective Serotonin Reuptake Inhibitors (SSRIs): Commonly prescribed for depression and anxiety, SSRIs can help reduce the obsessive-compulsive aspects of trichotillomania.
  2. Other Medications: Other types of medications, such as antipsychotics or mood stabilizers, may be considered based on individual needs and co-occurring conditions.

As the exploration of trichotillomania comes to an end, it’s evident that this disorder demands both understanding and action. Through education, empathy, and access to effective treatment options, the tide of this disorder can be turned back, offering hope and a brighter future for those affected.

 “Strength does not come from winning. Your struggles develop your strengths. When you go through hardships and decide not to surrender, that is strength”

– Arnold Schwarzenegger

About Hope and Belief 

Hope and Belief is an online resource for exploring the incredible potential of mind power and the transformative power of thoughts while nurturing mental health. We are dedicated to empowering individuals with valuable insights, techniques, and resources to harness the power of their minds for personal growth and well-being. Our goal is to disseminate the profound impact of positive thinking, visualization, affirmations, and mindfulness practices as we delve into the fascinating realm of mind-body connection. Whether you’re seeking guidance for overcoming challenges, managing stress, or cultivating a resilient mindset, Hope and Belief offers a wealth of articles, tips, and exercises to support your mental and emotional journey. Start your journey by unlocking the remarkable capabilities of mind power, understanding the power of thoughts, and fostering a life filled with hope, belief, and profound mental health.

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