What is Trichotillomania? Symptoms, Causes, Treatment

We all experience stress and anxiety in our routine lives and express it in our own ways. Some people with trichotillomania condition experience a great urge to pull their hair. However, when you pull your hair repetitively, it could make you bald and cause a lot of emotional distress. Today, we’ll discuss what is trichotillomania; its symptoms, causes, and treatment.

What is Trichotillomania? 

Trichotillomania (TTM) is a mental illness where a person would experience a great desire and urge to pull out their hair. Research studies have shown that roundabout 0.5% to 2% of people experience TTM.

Many people experience TTM conditions in their childhood and they pull out the hairs on their scalp, and usually, their focus is on one or more areas. However, people with TTM conditions don’t limit themselves to the scalp of pulling their hairs. After that, they would pull out hairs from other areas of their body that has hairs like eyelashes, eyebrows, etc. It results in the form of thinning of hairs and bald spots.

Usually, TTM develops in the adolescent years, but it is common in young children. Once it starts exhibiting symptoms, it would continue to prevail for many years to adulthood. It impacts both men and women equally at a young age, but it is more common among women in their adult years.

Studies have shown that some females feel more urge to pull out their hair at the start of their menstrual cycle. A study in 2018 showed that the hormonal changes in the female’s body at the start of their menstrual cycle would cause the development of the symptoms of trichotillomania, but researchers don’t know why it happens.

A study conducted in 2013 showed that the hormonal changes during pregnancy may cause the development of the symptoms of TTM. Studies have been going on to explain this condition.

Symptoms of Trichotillomania 

Some of the main symptoms of trichotillomania are as follows;

  • Feeling relieved after hair pulling
  • Trichophagy or hair eating
  • Tear off pieces of hairs
  • Repetitively pulling out your hairs

Some of the areas of hair that you pull are as follows;

  • Public hair
  • Beards
  • Eyelashes
  • Eyebrows
  • Scalp

The side effects that people with TTM experience over time are as follows;

  • Social anxiety
  • Skin irritation
  • Hair thinning
  • Bald spots in your head
  • Tingling or itching in those areas where you pulled out hairs

Causes of Trichotillomania 

Researchers don’t know the exact causes of trichotillomania and why it happens. Many experts believe that TTM develops due to environmental and genetic reasons. A study conducted in 2016 showed that the symptoms of TTM usually occur in a typical age of 10 to 13 years old. Usually, the symptoms begin with pulling out the hairs on the scalp, and it lowers the feelings of anxiety and stress.

People with TTM conditions don’t even realize the fact that they’re pulling out their hairs. When they start acknowledging that they’re pulling out their hair, it makes them feel embarrassed and anxious. In short, it develops the cycle of anxiousness, hair pulling, relieved feelings temporarily, ashamed, and hair pulling again. TTM has an association with many other mental health issues, and they’re as follows;

  • ADHD (attention deficit hyperactivity disorder)
  • Autism
  • Depression
  • Anxiety
  • OCD (obsessive-compulsive disorder)

It doesn’t mean that the person with the abovementioned conditions would develop TTM. The symptoms would be with following reasons;

  • Stress, shame, anger, boredom, anxiety, and other emotions
  • The sensation of pulling out their hairs on the scalp
  • Feelings and enjoying thickening of finger hairs

Diagnosis of Trichotillomania 

In order to diagnose trichotillomania, the person would have to meet the following criteria laid down by DSM-5;

  • No other mental disorder is better explaining the symptoms of hair pulling like planning to improve the flaws in your appearance as of body dysmorphic disorder or improving perceived defects
  • Hair loss or hair pulling is not happening due to other medical conditions like dermatological conditions
  • Hair pulling causes a lot of distress and impairment in occupational, social, and other areas
  • Planning to stop or reduce the hair-pulling urge repetitively
  • Pulling your hair repetitively results in the form of hair loss

Treatment of Trichotillomania 


Some of the main antidepressants and antipsychotic medicines that your doctor would suggest are as follows;

  • Quetiapine (Seroquel)
  • Clomipramine (anafranil)
  • Olanzapine (Zyprexa)
  • N-acetylcysteine

Behavioral Therapy

Studies have shown that stimulus control and HRT (habit reversal training) is very beneficial for treating the symptoms of TTM.

HRT works in the following ways;

  • Applying the newly learned skill in different setting
  • Staying motivated and not repeating the habit of hair pulling
  • Replacing hair-pulling habit and behavior with something else
  • Amplifying the awareness of the person about TTM triggers and symptoms

Stimulus control works in the following ways;

  • Eliminating and decreasing the sensory factors
  • Recognizing the sensory factors and situations that are causing you to pull hairs

Conclusion: What is Trichotillomania? Symptoms, Causes, Treatment 

After an in-depth study of what is trichotillomania; its symptoms, causes, diagnosis, and treatment; we have realized that TTM may jeopardize your health badly. If you’re experiencing its symptoms, then you should consult with a mental health professional and find any suitable behavioral therapy for you.