Description

Trichotillomania (trik-o-til-o-MAY-nee-uh), also called hair-pulling disorder, is a mental health condition. Involves frequent, repetitive, irresistible urges to pull out hair from the scalp, eyebrows or other areas of your body. You can try to resist the urges, but can't stop. Trichotillomania is part of a group of diseases known as body-focused repetitive behaviors.

Pulling out hair from the scalp often leaves patchy baldness. This can cause a lot of distress and can affect work, school, and social life. You can go to great lengths to hide the hair loss.

For some people, trichotillomania may be mild and can be managed. For others, the automatic or deliberate temptation of pulling the hairs is too much to handle emotionally. Some treatment options can help to reduce the hair-pulling or stop it completely.

Symptoms

The symptoms of trichotillomania often include:

  • Repeatedly pulling her hair, whether automatically or purpose, usually from their scalp, eyebrows or eyelashes, but sometimes from other areas of the body. The sites may vary over time.
  • An increasing sense of tension before pulling your hair, or when trying to resist pulling.
  • A sense of pleasure or relief after the hair is pulled out.
  • The loss of hair that is easy to see, such as shortening the hair or thinned or bald areas on the scalp or other areas of your body. This can include a thin or a lack of eyelashes or eyebrows.
  • Pulling of the specific types of hair, take the same steps in the same way, every time you pull the hair or pulling of the hairs in certain patterns.
  • Biting, chewing or eating the strip of hair.
  • Playing with the strip of hair or rub it across your lips or face.
  • Repeatedly trying to stop the pulling of his hair or trying to do it less often without success.
  • Experiencing a lot of distress or problems at work, school or in social situations related to pull your hair.

Often trichotillomania also includes picking up your skin, biting your nails or chewing your lips. Sometimes pulling of the hairs pets or dolls or the materials, such as clothing or blankets, it can be a sign. Pulling the hairs is usually done in private. An episode can last from a few seconds to hours. You may try to hide their condition from others.

With trichotillomania, hair pulling, can be:

  • Automatic. You can pull your hair without even realizing you're doing it. This could occur, for example, when you are bored, reading or watching TV.
  • Focused. You can pull your hair with the purpose of relieving the tension or distress. You can build specific rituals to pull the hair, such as the search for just the right hair. You can play, biting or eating out of the hairs.

You can do automatically and focused hair-pulling, depending on the situation and your mood. Certain positions or activities that may trigger pulling of the hairs, as a resting his head on his hand or brushing your hair.

Trichotillomania may be related to the emotions, including:

  • The negative feelings. Pulling of the hairs can be a way of dealing with the negative or negative feelings, such as stress, anxiety, tension, boredom, loneliness, extreme tiredness or frustration.
  • The positive feelings. You may find that pulling the hairs feel satisfaction and provides some relief. As a result, you can continue to pull his hair to keep these positive feelings.

Trichotillomania is a chronic disorder. If not treated, the symptoms can appear and disappear for weeks, months, or years. Also, the symptoms can vary in severity over time. For example, hormonal changes during menstruation can worsen symptoms in some women. Rarely, pulling the hair ends within a couple of years of the game.

When to see a doctor

If you can't pull your hair or feel ashamed by their appearance as a result, talk with your health care provider. Trichotillomania is not just a bad habit, it is a mental health condition. It is not likely to improve without treatment.

Causes

The cause of trichotillomania is unclear. But like many complex disorders, trichotillomania is the result of a combination of genetic and learned factors.

Risk factors

These factors tend to increase the risk of trichotillomania:

  • The history of the family. Genetics may play a role in the development of trichotillomania. You can have more chances of having the disease if you have a close relative with trichotillomania.
  • Health conditions. Some people may have the hair or skin conditions that are uncomfortable. This can focus your attention towards pulling hair or pick at your scalp.
  • Age. Trichotillomania usually develops just before or during adolescence — most often between the ages of 10 and 13 years. It is often a lifelong problem. Babies can be out of the hair, but this is usually mild and goes away by itself without treatment.
  • Other mental health conditions. Other conditions, such as depression, anxiety, or obsessive-compulsive disorder (OCD) may occur along with trichotillomania.
  • Stress. Severely stressful situations or events may trigger trichotillomania in some people.
  • Environment. The boredom, the isolation and privacy, with frequency, increase the likelihood of pulling the hair.

Although far more women than men are treated for trichotillomania, this may be because women are more likely to seek medical advice. In early childhood, trichotillomania occurs so often in boys and girls.

Complications

Although it does not seem serious, trichotillomania can have harmful effects on your life. Complications can include:

  • The emotional distress. You may feel frustrated, embarrassed because of your condition and the loss of hair. You may feel that you have no control over pulling her hair. You can experience low self-esteem, depression, anxiety, and problems with alcohol or drugs.
  • Problems in your social life and work. The hair loss can lead to the avoidance of social activities and school and work opportunities. You can use wigs, style your hair to cover bald patches or wear false eyelashes. You can avoid the intimacy to hide their condition.
  • The skin and the hair from damage. Constantly pulling out hair can cause scarring, infections and other harms to the skin of the scalp or the area where the hair is pulled out. This can permanently affect the growth of the hair.
  • Hairballs. Eat your hair can lead to a large matte hairball that remains in the digestive tract. Over a period of years, the hairball can cause weight loss, vomiting, intestinal block, and even death.

Diagnosis

For the diagnosis of trichotillomania, it is likely to begin by having a physical examination. Then, you may be referred to a mental health professional with experience in the treatment of trichotillomania. The diagnosis of trichotillomania may include:

  • The examination of your hair loss.
  • Check possible medical causes for your hair loss. This may include lab tests.
  • To talk to you about the hair loss, including their behaviors and emotions related to pull your hair.
  • The identification of any physical or mental condition of the health conditions that can occur along with pull your hair.

Treatment

Some treatment options have helped many people to reduce the hair-pulling or stop completely. These include therapy and sometimes medicine.

Therapy

The types of therapy that may be useful for trichotillomania include:

  • Habit reversal training. This behavior of the therapy is the main treatment for trichotillomania. You will learn to recognize the situations where you are very likely to pull out their hair and how to replace the behaviors of others in their place. For example, you can tighten your cuffs to help stop the momentum. A form of habit reversal training, called dissociation, involves quickly redirect his hand from your hair to another location when you feel the need to pull your hair. Other therapies may be used along with habit reversal training.
  • The therapy, acceptance and commitment. This therapy can help to learn to accept their hair-pulling urges without acting on them.
  • The cognitive therapy. This therapy can help you to identify and examine the beliefs that you hold about the hair-pulling that they are not realistic. You can learn healthy ways to think about your condition.

Therapies that help with other mental health conditions that often occur together with trichotillomania, such as depression, anxiety, or problems with alcohol or drug use, can be an important part of the treatment.

Medications

Although there are no medications approved by the Food and Drug Administration specifically for the treatment of trichotillomania, some medications can help control some symptoms, such as anxiety and depression.

For example, your health care provider may recommend antidepressants, such as clomipramine (Anafranil). The research suggests that N-acetylcysteine (as-uh-tul-SIS-tee-een), an amino acid that affects the mood, can also help. Another option that the research suggests that it may have a benefit is olanzapine (Zyprexa). This medication is used to treat certain serious mental health conditions that affect the mind.

Talk with your health care provider about any medications recommended. The potential benefits of medications must be balanced against possible side effects.

Coping and support

You can find the treatment of trichotillomania challenging. This can help to join a support group for people with trichotillomania, so that you can meet others with similar experiences who can relate to their feelings and offer support. Have a family member or loved one to join you to learn how to respond to his hair pulling can also be useful.

Ask your doctor or mental health professional for a tip. The TLC Foundation for Body-Focused Repetitive Behaviors is an excellent resource for the education, support, and options for treatment of trichotillomania.

Preparing for your appointment

Seeking help is the first step in the treatment of trichotillomania. At the beginning, you can see your primary care provider or a specialist in disorders of the skin called a dermatologist. Your doctor may refer you to a mental health professional with experience in the diagnosis and treatment of trichotillomania.

What you can do

Before your appointment, make a list of:

  • All of your symptoms, even if they seem unrelated to hair pulling. Trichotillomania can cause both physical and mental health symptoms. Note what triggers your urges, how you've tried to deal with them, and what makes the urges for better or worse.
  • Key personal information, including any major stresses or recent life changes. If no one in your family has trichotillomania.
  • All the drugs, vitamins, herbs, or other supplements you are taking, including the dosage and how long you have been taking.
  • Questions to make the most of your appointment time.

Questions include:

  • What caused me to develop this condition?
  • How do I know if I have this disease?
  • Is this something that will go away on its own?
  • What treatments are recommended?
  • If I decide to take medications, how long will it take for my symptoms to improve?
  • What are the side effects of the medications that you are recommending?
  • What can I do in addition to treatment to improve the symptoms?
  • What improvements can you expect with your treatment plan?

Do not hesitate to ask questions during your appointment.

What to expect from your doctor

It is likely that he will ask a series of questions, such as:

  • When did you start to pull your hair?
  • How to pull your hair automatically, purpose, or both?
  • Have you tried to stop the pulling of your hair? How does it work?
  • There are moments or situations that may trigger hair pulling?
  • What feelings do you have before and after you pull your hair?
  • Of where in your body that will pull the hair?
  • Make biting, chewing, or swallowing the strip of hair?
  • How has hair pulling affected your work, school or social life?
  • Have you had the treatment, such as therapy or medication, hair pulling, or other emotional problems?

Be prepared to answer questions, so that you'll have time to talk about what's most important to you.

Symptoms and treatment of Trichotillomania (hair pulling disorder)