Trichotillomania (Hair Pulling Disorder) - Symptoms, Causes, Diagnosis, and Treatment

Trichotillomania (Hair Pulling Disorder) - Symptoms, Causes, Diagnosis, and Treatment

Trichotillomania, also known as a hair-pulling disorder, is a physical and mental disorder that involves unintentional recurring hair pulling from the scalp, eyebrows, or other areas of your body.

Continuous hair pulling may leave patchy bald spots on your scalp, which cause significant distress and can hinder work or social functioning. People suffering from Trichotillomania may go to great lengths to hide hair loss.

Trichotillomania is mild and usually manageable for some people, but the irresistible urge to pull hair is overwhelming for others. Some treatment options help people reduce their hair pulling or stop entirely.

Read on to know more about Trichotillomania.

Signs and Symptoms of Trichotillomania

Other symptoms of Trichotillomania besides repeated hair pulling include:

  • Feel relieved, pleased, or satisfied after acting the impulsive hair pulling
  • Distress problems in their working environment or social gathering due to regular hair pulling
  • Behavioral changes like inspecting the hair root, pulling the hair between the teeth, twirling the hair, chewing on hair, or eating hair
  • Prefer specific textures or types of hair
  • Bare patches where you pull out your hair
  • Feeling tense when trying to resist the urge to pull hair or before pulling hair

People with Trichotillomania can also have other disorders that often come with it, like skin picking disorder or onychophagia (nail biting disorder). Pulling fibers from blankets or hair from dolls is another symptom of having Trichotillomania.

Many people who have Trichotillomania may also pick their skin, chew their lips, or bite their nails. Most people who suffer from Trichotillomania pull their hair privately to hide this disorder from others.



Causes of Trichotillomania

The exact reason of what causes a person to develop Trichotillomania is till date is unknown. Many people report that hair pulling helps to reduce stress or boredom. 

However, certain factors can increase the risk of developing Trichotillomania in a person. These risk factors are:

  • Genetic history- A person who has a blood relative, maybe a parent or sibling with Trichotillomania is more likely to develop this condition themselves.
A person may be more likely to have Trichotillomania if they have experienced childhood trauma. However, there is no specific research to support this idea.
Certain changes like a person’s ability to control impulsive behaviors, such as hair pulling in brain function or chemistry, can lead to Trichotillomania. 
  • Stress- Several stressful situations or events may cause Trichotillomania in some people.
  • Age- Trichotillomania generally develops during or just before the early teens (most often between 10 to 13 years and may last a lifetime). Sometimes infants can also be subject to hair pulling, but it is usually mild and goes away without any treatment on its own.
  • Other disorders- People suffering from Trichotillomania may also have other disorders, like anxiety, depression, or obsessive-compulsive disorder (OCD).


Types of Trichotillomania

Although all Trichotillomania involves pulling hair from different body parts, there are two major types: automatic and focused pulling.

  1. Automatic hair pulling- In this type of hair pull, a person does not realize whether they are doing it until after the fact. For example, you could be zoning out watching television, then suddenly look down and realize that the sitting is full of hair you pulled out.
  2. Focused hair pulling-  In this, hair pulling is done very intentionally in this type of Trichotillomania because it feels good to a person. Usually, focused hair pullers wait to engage in the behavior until they are in their private space.

It will help establish the correct treatment if determining which type of hair pulling a person is engaged in. It’s not as simple as looking at hair-pulling behavior, but it understands the function behind it. Doctors do it via interviews and questions and answers.

In addition to these two Trichotillomania types, another side of the behavior is what people do with their hair. Some people pull their hair and throw it on the floor, or some people will save the hair in pouches. Sometimes, people may even pull the hair out and inspect whether the pulled hair strands have roots and if yes, they might play with the roots or roll the hair in their fingers. A few people might bite hair stands, pull the strand of their hair from their lips, and in some cases, they might swallow as well.

Eating and swallowing the hair that people pull can result in medical complications; it’s essential to determine how and when they are pulling their hair and what they are doing with it.


Diagnosis for Trichotillomania

Your doctor will talk to you about your medical or genetic history and all the symptoms you may be experiencing to diagnose Trichotillomania. According to the doctors, someone diagnosed with Trichotillomania must meet the following:

  • Recurring hair pulling causes significant distress or impairment in work, social or occupational functioning.
  • Recurrent pulling out one’s hair results in significant hair loss.
  • The symptoms of another mental disorder don’t explain hair pulling better; for example, attempts to improve a perceived flaw or defect in appearance in body dysmorphic disorder. 
  • Repeated attempts to decrease or completely stop hair pulling.
  • Hair pulling or hair loss is not accountable to other medical conditions like a dermatological condition.

Your doctor may also rule out other hair loss causes and send you to a dermatologist (skin doctor).


Can Trichotillomania Be Cured?

Trichotillomania can have an extremely negative impact on a person’s life. Trichotillomania (hair-pulling disorder) not only causes obvious physical issues but may also lead to a host of negative emotional and mental symptoms. Some of these negative mental and emotional symptoms may include:

  • A need for societal withdrawal and isolation
  • Shame in interacting with people
  • Guilt for not being able to cope with the world because of Trichotillomania disorder
  • Embarrassment in public gatherings
  • Low self-esteem

Because of the disorder’s symptomatic exceptionally high stakes, many people have a keen interest in knowing a cure for Trichotillomania. And if yes, will it work for them or not?


Treatment for Trichotillomania

There is limited research on the treatment of Trichotillomania. But still, some treatment options can help people reduce their hair pulling or even stop it entirely.

  • Therapy
  • Types of therapy that may help in treating Trichotillomania include:

    1. Habit reversal training- This is a behavior therapy that primarily treatments Trichotillomania. It teaches how to recognize situations where people are likely to pull their hair and substitute other behaviors instead. 
    2. Cognitive therapy- This therapy helps people recognize and examine distorted beliefs concerning hair pulling.
    3. Acceptance and commitment therapy. This therapy helps people learn how to accept their hair-pulling urges without acting upon them.

    Trichotillomania is often associated with therapies helpful with other mental health disorders, like depression, anxiety, or substance abuse, which can be important for treatment.

  • Medications
  • Many kinds of research in 2014 have proven the efficacy of different medications in treating Trichotillomania, hair-pulling disorder. The drugs that were found effective during various trials in an experiment include:

    • olanzapine, which is an antipsychotic
    • selective serotonin reuptake inhibitors (SSRIs), which are a class of antidepressants
    • naltrexone, which is an opioid antagonist
    • clomipramine, which is a tricyclic antidepressant
    • N-acetyl cysteine

    The doctors and the reviewers identified N-acetyl cysteine, olanzapine, and clomipramine as the only drugs to have a remarkable treatment effect on Trichotillomania. Although, the experiment used a very small amount of sample sizes and did not even report information on side effects. Therefore, further controlled clinical trials are essential to determine the safest and most appropriate drug treatments for Trichotillomania.

    No Definitive Solution

    While several forms of treatment are available to aid a person suffering from a hair-pulling disorder, Trichotillomania, there is no official cure for it on the books presently. The reason for this, in a way, is a manner of semantics. The word “cure” implicates 100% success in eliminating a disorder or a condition. But currently, no study has yet figured out how to cure Trichotillomania with that perfect level of accuracy.

    This hair-pulling disorder itself remains somewhat of a mystery to physicians or doctors. How Trichotillomania presents itself has made tracking its origins and development difficult. For example, some people may develop it as a coping mechanism for depression or relief from an uncontrollable urge. Others may develop Trichotillomania in the wake of a traumatic event or an incident of high anxiety. 

    Because of these different distinctions or subcategories, much is still not discovered regarding Trichotillomania. Before a definitive method to cure Trichotillomania can be developed, These discoveries must happen.

    Although no treatment has gained success in treating Trichotillomania, you don’t need to lose hope because Emily Wyant and her expert team at Bond Hair Bar can help cope with this hair-pulling disorder. Let’s see how:


    Devices to Treat Trichotillomania at Bond Hair Bar

  • Hair Extensions

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    So, if you want to add a little hair for volume or look for gorgeous long and thick hair you have never been able to grow because of Trichotillomania, remember Bond Hair Bar has a solution for you. We have some of the most recognizable hair extensions with great Lengths, secret strands, ultra-links, no cap, seamless hair Extensions, Cinderella, and many more.

    We can provide you with the correct hair extensions according to your choice. For example, suppose you want some temporary attachment for a special occasion or something more permanent with less or no maintenance.


    • Non-Surgical Hair Replacement Systems 

    For most people, hair is much more than a physical attribute. It’s a part of who they are; it’s their self-esteem and something that makes them more confident.

    At Bond Hair Bar, we provide the most natural-looking solutions for all types of hair loss, including Trichotillomania. We re-create any hairstyle before hair loss with the help of custom hair systems.

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    Treat Trichotillomania with the help of Emily Wyant at Bond Hair Bar

    Most of you take Trichotillomania lightly, but it can cause stress, anxiety, or depression. Therefore, it is best to consult a good healthcare provider to ensure the information displayed on this page applies to your circumstances. 

    To deal with your hair-pulling disorder seriously with the help of Emily Wyant and her expert team at Bond Hair Bar. We offer non-surgical hair replacement and hair extensions for every state of hair loss.

    So, give us a call on +1 (650) 376-3582 or reach us via email at

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