Trichotillomania refers to an irresistible urge, or compulsion to pull hair out of your scalp, pulling out eyelashes, eyebrows, or other, and more private areas of your body. This urge can range from mild and occasional, to constant and overwhelming. When severe, this disorder can be quite obvious and embarrassing, especially when it results in bald patches on the scalp or loss of eyebrows and/or eyelashes.


The external signs and symptoms of trichotillomania often include:

  • Repeatedly pulling your hair out, either consciously or absent-mindedly.
  • An overwhelming, or almost overwhelming urge to pull your hair, followed by feelings of relief after the hair is pulled.
  • Bald patches on scalp or other areas of your body.
  • Thin or missing eyelashes or eyebrows.
  • Unusual or abnormal actions with pulled-out hair; playing with it, rubbing it across lips or face, chewing or eating it.

However, most people with trichotillomania pull hair in private and generally try to hide the disorder from others, sometimes by going to great lengths (wigs, unusual hairdos, heavy use of mascara, eyebrow pencil or false eyelases) to hide the evidence.

Trichotillomania is classified by the APA (American Psychological Association) as one of a large variety of “anxiety disorders”. But like many other complex disorders, a combination of genetic and environmental factors can probably contribute to the development of trichotillomania. Mental health professionals believe this disorder to be a combination of genetic (physical) causes, such as (possibly) inherited imbalances of brain chemicals combined with environmental causes such as emotional or physical stress; loneliness, anxiety, frustration, fatigue (tiredness), or many others.


Risk factors for Trichotillomania are:

  • Family history when other family members have anxiety disorders
  • Age Trichotillomania usually develops during adolescence
  • Gender Females seem to be more often affected than males
  • Negative emotions possibly as a result of depression, low self-esteem or poor coping skills
  • Sensation of “positive reinforcement” – when hair-pulling creates a sensation of relief from agitation or emotional pain
  • Symptoms of other depressive or anxiety disorders depression, anxiety, obsessive-compulsive disorder or eating disorders.
  • Physical “bad habits” such as nail-biting or skin-picking.


Trichotillomania may not, at least at first, seem like a serious problem but it can have serious side-effects:

  • Emotional distress. Many people with trichotillomania experience low self-esteem, depression and anxiety because of their condition.
  • Social problems. Embarrassment because of hair loss may lead you to isolate yourself from friends and family, and avoid swimming, haircuts and windy weather. Some sufferers also avoid intimate relations due to shame
  • Skin damage. Constant hair pulling can cause damage, including skin infections and the possibility that hair might not grow back.
  • Hairballs. Eating your hair may lead to having a large, matted hairball in your digestive tract. A hairball can cause weight loss, vomiting, intestinal obstruction and even death.

Preparing for your appointment

Conventional treatments of Trichotillomania include psychotherapy (counseling) and medications. Counseling can help the client understand the conditon and where the behavior comes from. Counseling can also help the client learn to recognize the “triggers” or situations where they might start hair-pulling and learn to substitute other behaviors for hair-pulling. Medications, such as an antidepressant migh also be prescribed as short-term or long-term help. Other types of help available that might work hand-in-hand with conventional treaments for trichotillomania are hypnosis, use of relaxation techniques, and support groups.