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The History of Trichotillomania

Trichotillomania is an anxiety disorder similar to obsessive compulsive disorder (OCD). People who suffer from trichotillomania repeatedly pull out hair from the scalp, eyelashes and eyebrows and feel a sense of relief afterward. Patients may also pull out body or pubic hair, depending on the extent of their condition.

  1. The Facts

    • Typically, before people with trichotillomania begin pulling out their hair, they experience severe anxiety. Patients learn that compulsive hair pulling relieves stress and anxiety, which reinforces the behavior. Some patients become symptomatic in stressful situations. Others experience symptoms when they are resting or engaging in simple activities that require little concentration, like watching TV. However, all patients feel anxiety or stress prior to becoming symptomatic, regardless of the activity.

    Significance

    • Trichotillomania is diagnosed more often in women than men, but children are diagnosed at a ratio of 1:1. For most people, symptoms begin in childhood or adolescence, but people have been diagnosed before the age of one. Previously, researchers believed trichotillomania was very rare with an incidence of .05 to .6 percent. More recent studies reveal up to three percent of the population may suffer from trichotillomania, according to the OCD Resource Center of Florida.

    Features

    • In addition to compulsive hair pulling, other symptoms associated with trichotillomania include nail biting and excessive scratching. Patients can also engage in trichophagia, which involves compulsively eating hair. Physicians should be careful not to confuse this symptom with Pica, a disorder characterized by eating nonfood objects. People with trichotillomania may also suffer from depression or other anxiety disorders.

    Identification

    • Trichotillomania should only be diagnosed after all other possible reasons for hair loss have been ruled out. Broken hairs, damaged follicles, large patches of hair, and inflammation on the skin can be used to diagnose trichotillomania. Some patients pull out enough hair that nothing is left but a small rim. Others only pull out small, unnoticeable sections in an attempt to hide their disorder. Trichophagia can result in stomach pain.

    Treatments

    • While anxiety disorders like trichotillomania have no cure, symptoms can be managed with various techniques, including habit reversal training, a treatment that involves identifying the feelings that lead to compulsive hair pulling. Some patients benefit from hypnotic techniques, but hypnosis is not a widely effective treatment. When behavioral modification techniques don't work, some patients turn to medication to help manage their symptoms. Prozac, Zoloft and Paxil are medications that have been used to treat trichotillomania.

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