Trichotillomania is compulsive hair pulling that causes hair loss, aka alopecia. It is classified as an impulse control disorder that often starts as a young teen, with this compulsive behavior predominantly seen in females.
What causes trichotillomania is not fully understood, but the onset of compulsive hair pulling is often associated with a stressful event. Also, hormonal changes and neurotransmitter imbalance of serotonin and/or dopamine may play a biological role as well.
As expected, compulsive pulling of your hair causes noticeable hair loss, which is the primary symptom of trichotillomania. Your alopecia could be in round patches or all over your head. And the need to pull hair may involve other areas causing eyebrow and eyelash loss.
For some, trichotillomania is complicated by eating their pulled-out hair, aka trichophagia. This behavior can lead to other health conditions, such as intestinal blockage, bezoars, digestive problems, malnutrition and anemia.
Hair pulling episodes are typically done while in a trance like state, culminating in a sense of relief, pleasure or gratification after the loss of hair. So, if you have trichotillomania you may not be fully appreciate why you have alopecia.
Treatment for compulsive hair pulling starts by ruling out other possible causes for hair loss, which include:
- radiation
- ringworm
- blepharitis
- alopecia areata
- skin conditions ~ psoriasis
- infectious diseases ~ herpes zoster
- fungal skin infections ~ tinea capitis
- endocrine disorders ~ hypothyroidism
It’s not uncommon for anxiety and depression to occur in concert with trichotillomania, in addition to other compulsive behaviors like nail biting, excessive scratching and skin picking.
Effective treatment for trichotillomania are behavioral therapy and drugs. Habit reversal training and stimulus control are two types of behavioral therapies employed. And naltrexone and SSRIs have been shown to help with the compulsions, causing hair pulling urges to diminish in intensity.
Alternative forms of treatment for your hair loss are hypnosis, biofeedback, yoga and exercise. Stress management techniques can also help because stress can trigger your compulsive hair pulling caused alopecia.
And conceivably your patches of hair loss regrow because you’ve outgrown your hair pulling compulsiveness.