Trichotillomania

Trichotillomania, or compulsive hair pulling, is a type of obsessive-compulsive disorder, in which individuals experience an overwhelming urge to pull out their hair. The most common sites for hair pulling are the scalp or face, although individuals may pull hair from other areas such as arms, legs, public region, underarms, or other areas of their body. Episodes of pulling can last anywhere between several minutes to several hours. In order to extract hair, individuals may use their fingers or tweezers to pull one hair at a time. Pulling out large clumps of hair at once is unusual in these cases. Individuals with trichotillomania engage in two types of behaviours: focuses and/or automatic pulling. Focused pulling typically occurs in response to an internal state (e.g. anxiety, sadness, stress, shame) or triggered by an stressful external event and is used to relieve tension or distress. Automatic pulling occurs out of the individual’s awareness, often while watching television or reading. 

Some signs and symptoms of trichotillomania may include: 

• Compulsive pulling of hair 
• Repeated but unsuccessful attempts to reduce or stop pulling 
• Increased tension prior to pulling or when trying to resist pulling 
• A sense of pleasure or relief after hair is pulled 
• Biting, chewing, eating, or playing with pulled out hair 
• Noticeable hair loss or bald spots due to hair pulling
• Skin irritation at affected sites 
• Significant impairment or disruption in life functioning 

Many people with trichotillomania may not know that they have a condition and may simply view hair pulling as a bad habit. For others, the compulsive urge to pull hair can be overwhelming and cause significant distress and impairment in their lives.