Trichotillomania is a condition which is characterised by impulsive hair pulling. This is often used as a way to manage difficult or negative emotions. This disorder can result in individuals pulling hair from their head, eyebrows, eyelashes, or any other area of the body which has hair on it. For some people, the urge to pull hair is severe and uncontrollable; for others, it is niggling and only intensifies in challenging times.

Trichotillomania hair pulling disorder is often seen as a way to manage negative or anxious feelings. It is comparative to other forms of self-harm in that carrying out this behaviour can provide a short sense of relief for the person. Sometimes people are aware of their actions and consciously pull out their hair; however, others do it subconsciously while they are engaged in another activity.

Like all mental health conditions, trichotillomania hair pulling disorder is a serious and debilitating condition. Many individuals living with this condition report feelings of shame and embarrassment about their behaviour. Trichotillomania is nothing to feel ashamed or secretive about; those living with it deserve quality treatment and compassion. With the proper support and medical intervention, there are ways to manage this condition and live a full and happy life.

Who Does Trichotillomania Affect?

This condition often develops in childhood or early teenage years. Studies have found that the most common age for onset of symptoms is between 10 and 13 years.

It is possible for trichotillomania to eventually develop into trichophagia – the impulsive act of eating the hair that is pulled out. It is thought that around 20% of individuals with trichotillomania eat their hair after pulling it out.

Mental illness, low self-worth and social anxiety are all linked to trichotillomania hair pulling disorder, partly due to the compulsion to pull and often resulting in visible hair loss. Individuals with this condition often report being unable to hold down or pursue jobs due to shame or low self-worth. Nearly one in three adults with the condition report a low or very low quality of life.

Identifying a Hair Pulling Disorder

Every case of trichotillomania is unique. Those living with the condition will display different signs and symptoms of the disorder; however, there are some common indicators to look out for if you suspect a case. These include:

• Compulsive body-focused repetitive behaviours (this could include nail biting, skin picking or hair pulling behaviour)
• Hair pulling urges
• Bald areas
• Noticeable hair loss
• Hiding hair loss
• Isolation
• Keeping pulled hair
• Feelings of satisfaction or relief after hair pulling

What Causes Trichotillomania Hair Pulling?

It is thought that a number of factors contribute to trichotillomania. A combination of genetic and environmental factors are linked to developing the condition. Some of the most common risk factors for this disorder include the following:

• Genes – individuals with a history of trichotillomania in their family are more susceptible to developing this hair pulling disorder.
• Co-existing mental health conditions – those who develop trichotillomania are likely to have other mental health conditions, such as obsessive-compulsive disorder, anxiety, eating disorders or depression.
• Age – though not exclusively, this hair pulling disorder is most common in children and young teenagers.
• Stressful life events or grief – in some cases, stress is a trigger for trichotillomania due to the fact that the disorder often brings initial feelings of release, relief, and happiness.

Trichotillomania Diagnosis

There is no set test to diagnose trichotillomania; instead, the condition is usually diagnosed due to the presence of common symptoms. Treatment depends on the severity and frequency of symptoms as well as the individual’s age.

If there are signs of another underlying mental illness, medical staff may test for other disorders and include treatment for both conditions.

If you suspect that you or someone you know is displaying signs of hair pulling behaviour, seek medical advice as soon as possible. The nature of the condition can make it hard to spot, but if left untreated, it can cause further emotional and physical damage.

Co-occurring Disorders

People with trichotillomania have increased rates of co-existing disorders, most commonly, anxiety and depression. Anxiety is the most significant co-occurring mental disorder in children with this condition. It is currently still unknown which of these related disorders appears first. In some cases, it is thought that pulling hair may be a response to anxiety or obsessive-compulsive disorder.

On the other hand, pulling hair often leads to low-self esteem and feelings of self-worth. For many individuals, hair pulling behaviour leads to isolation and avoiding social gatherings, which can perpetuate other mental disorders such as anxiety and depression.

Can Trichotillomania Be Treated?

With the proper treatment and care, symptoms of this condition can be greatly reduced. Many individuals who enter treatment for trichotillomania go on to live fulfilling and satisfying lives. A combination of therapies and alternative treatments can provide healthier coping mechanisms for life’s challenges and reduce the urge for hair pulling.

Some common treatments include:

Habit Reversal Therapy

This is a form of therapy designed to tackle damaging habits such as trichotillomania and help people to focus on other less destructive behaviours. This is a commonly used treatment for people with trichotillomania. It may see individuals focussing their energy on harmless movements such as finger tapping or squeezing an object.

Talk Therapies

Therapies such as cognitive behavioural therapy (CBT) and dialectical behavioural therapy (DBT) can help individuals identify the negative patterns of thought which may result in hair pulling. These therapies help individuals establish healthier strategies for coping with difficult feelings and emotions.

Group Therapy

Group therapy can be extremely beneficial for people with trichotillomania hair pulling disorder. The sense of community and support they gain from these groups can help them increase their sense of self-worth. Isolation is a common side effect of mental illness; group therapy tackles this and encourages individuals to share stories of hope, ideas for the future and a sense of togetherness.

Medication

There are currently no medically approved prescriptions for this condition, but some people may find certain antidepressants or antipsychotic drugs reduce the urge for hair pulling.

If an individual is experiencing an underlying mental health disorder, medication may relieve them of the challenging symptoms that hair pulling could be a result of. For this reason, it’s crucial that treatment includes screening for other disorders.

The Risks of Untreated Trichotillomania

Untreated mental illness of any kind poses mental and physical health risks for the individual. Trichotillomania is no different. Nobody should suffer in silence; doing so can have deep and lasting effects, such as: 

• Skin and Hair Damage

It’s common for individuals living with this condition to have visible damage to their skin and hair. This can include scarring, bald patches, or red marks. This is likely to impact their self-esteem and can pose physical health risks such as infection, permanent hair loss or permanent scarring.

• Emotional Distress

Those living with this condition commonly report emotional pain and distress. This can be in the form of shame, embarrassment, guilt or loneliness.

• Further Mental Illness

Living with trichotillomania puts individuals at a higher risk of developing other mental illnesses. This is in part due to the isolation and low self-esteem as a result of their condition.

• Digestive Problems

If trichotillomania develops further into trichophagia, the digestive system can become damaged by hair going through the system over time.

• Isolation and Loneliness

Living with this condition can negatively impact other areas of life. Some people may try to avoid social activities due to feelings of embarrassment or shame. This can result in broken relationships, loss of jobs or careers, and overall reduced mental wellness.

Coping With Urges to Pull Hair

In addition to therapy, there are several things which individuals can do on their own to cope with their condition. This can give an empowering sense of agency in the recovery process.

• Mindfulness

Hair pulling is often a result of unmanaged stress or anxiety. Using tools such as mindfulness can ground you in the present moment and reduce difficult emotions. Activities which focus you on the present moment, such as yoga, colouring or gardening, can reduce the intensity to pull.

• Stress Reduction Tools

Some people find tools such as stress balls or fidget spinners incredibly helpful in managing urges. These can work as part of habit reversal training in order to displace the need to pull hair.

• Know Your Triggers

Everyone’s experience is unique, and noticing what your triggers are can arm you with important information in reducing body-focused repetitive behaviours such as hair pulling. For some people, certain environments, people or places can trigger this behaviour. Make an effort to notice what your triggers are and work to avoid or minimise them, particularly if you are already feeling stressed or low.

• Support Communities

There are a number of support communities for individuals living with this condition. These are available online or in-person, depending on your personal preference. These groups can provide much needed support and advice for difficult days, as well as providing a safe and supportive environment to develop friendships and regain your social life.

The Revoke Programme Treatment Method

We know how damaging mental illness can be. If left untreated, you are vulnerable to a number of psychological and physical health implications.

The good news is treatment is available, and recovery is possible. Effective therapeutic work can help you overcome these challenges and arm you with healthier coping mechanisms and a supportive community to lean on during difficult days.

Our treatment is built around an intensive outpatient programme. This means that you can continue to fulfil your personal obligations while in recovery.

We know that every mental health condition is unique, and we reflect that in our tailored plans. You can expect the following and more if you choose The Revoke Programme:

• Cognitive-behavioural therapy (CBT)
• Dual diagnosis
• Targeted trauma treatment
• Guided group sessions
• Ongoing aftercare

Get in touch with us today if you want to learn more about our trichotillomania treatment. A member of our team at The Revoke Programme will be happy to take your call.