Trichotillomania Disease

People with trichotillomania suffer from an uncontrollable urge to pull out their hair. Although there has been debate over its classification as a disease, it is currently categorized with nail biting and skin picking as a "body-focused repetitive behavior." Although the disorder can cause both emotional and physical harm, it can be successfully treated through a combination of therapy and medication.

Definition

• The Trichotillomania Learning Center defines the disorder as a condition that "causes people to pull out the hair from their scalp, eyelashes, eyebrows, or any other parts of the body, resulting in noticeable bald patches."

  People experience varying degrees of the disorder. While some find their urges to pull hair easy to control, others experience urges so strong that they are unable to control their impulse to pull. Some individuals with severe trichotillomania pull hair subconsciously and may not even realize when they are doing it.

Symptoms

• Symptoms of trichotillomania can be difficult to detect because sufferers go to great lengths to disguise their condition by pulling from areas of the body that aren't immediately visible or hiding their bald patches with makeup or wigs. In addition to seeing bald spots, signs of the disorder include missing eyelashes or eyebrows, eating pulled hair or playing with pulled hair. The most common location for pulling hair is the crown of the head, leading some patients to develop a tonsure pattern. Also referred to as the"Friar Tuck" sign, this pattern resembles male pattern baldness.

Complications

• Trichotillomania is not as harmless as it may seem and can result in serious physical and emotional problems. In addition to feelings of shame and humiliation, patients may experience permanent hair loss because of damaged skin or hair follicles, carpal tunnel syndrome from the repetitive nature of pulling hair strands and even hairballs in those individuals who ingest their pulled hair. Although rare, ingesting large amounts of hair can lead to trichobezoars---a serious intestinal or stomach obstruction caused by clumps of hair. When left untreated, these blockages can be fatal.

Treatment

• Both Cognitive Behavioral Therapy and medications have proved effective in treating trichotillomania. During therapy sessions, patients will work on uncovering the triggers of their hair-pulling and learn how to redirect the impulse to pull. When choosing a therapist, it is important to choose someone who has experience working with trichotillomania patients.

  The most common type of medication used to control trichotillomania is selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft. The success of SSRIs in treating the disorder vary, with some patients experiencing a complete reversal in their desire to pull and others reporting no benefit from medication at all. In most cases, a combination of therapy and medication has been found to work best, according to the Trichotillomania Learning Center.

Support

• Like many other mental health disorders, there is no cure for trichotillomania. However, individuals can learn to manage their impulses and live a normal life without the pain and embarrassment of hair pulling. One of the best ways to deal with the disorder is through a solid support system of family, friends and peers.

  Local support groups and online forums can be a great way for hair pullers to find support and share their feelings with others who suffer from the disease (see Resources). Such participation can help individuals develop confidence and can even help reduce their urge to pull.