Rothman Center for Pediatric Neuropsychiatry

Trichotillomania (Hair Pulling)

What is Trichotillomania?

Trichotillomania (or hair-pulling) is a disorder characterized by the chronic compulsion of pulling out one's own hair, and it is associated with noticeable hair loss, distress, and functional impairment. Individuals suffering from trichotillomania often feel a compulsion to engage in a ritual associated with their hair-pulling (e.g., a need to bite the hair or root, tactile stimulation of lips or face with the hair shaft, a need to pull the hair in a particular way, searching for hairs that do not feel right or look right). Trichotillomania is a chronic and often disabling illness with a lifetime prevalence of 0.6-2.5%.

What are the causes of this condition?

The exact causes of trichotillomania are relatively unknown. However, research suggests that it may be caused by abnormalities in brain pathways involved in emotion regulation and impulse control. The neurotransmitters (brain chemicals) dopamine and serotonin are believed to impact the disorder as well.

Trichotillomania Symptoms

The symptoms of trichotillomania include recurring urges to pull out hair with a sense of gratification of relief after the behavior. Before the individual begins the hair-pulling, a sensation of anxiety is felt and can be made worse by resisting the urge. Because of the hair-pulling, areas of the body can be bald or sparsely hairy. The hair-pulling can also causes significant impairment in daily life:

  • Feeling tense before pulling hair or when trying to resist the urge to pull hair
  • Feeling gratification or relief after the hair has been pulled out
  • Bald patches where hair has been pulled out
  • Impairment in daily life

Trichotillomania Treatment