Trichotillomania is a strange disorder characterized by an irresistible urge to tear out one’s hair

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Trichotillomania is a strange disorder characterized by an irresistible urge to tear out one’s hair, usually on the scalp, eyebrows, and eyelashes.

Although people suffering from this pathology are aware of the harm they can do to themselves by acting in this way, they are unable to stop or control this impulse. In addition, during times of stress, such people often try to pull their hair out to calm themselves, thus creating a vicious cycle that can cause even more damage both physically and psychologically.

What is trichotillomania?

The condition usually manifests around age 13 and is officially classified as an impulse control disorder, the same as pyromania, kleptomania, or pathological gambling addiction. It is also closely related to obsessive-compulsive disorder because they share many symptoms and maladaptive psychological mechanisms.

It is common in 1% of the population and affects both men and women, although women are more likely to seek treatment.


Trichotillomania is characterized by the presence of the following symptoms:

  • Recurrent hair pulling, causing significant hair loss (as seen in photo).
  • Increased perception of stress immediately prior to hair pulling or resistance to hair pulling.
  • Pleasure, satisfaction, or release from hair pulling.
  • The disorder is not explained by another mental disorder or medical condition.
  • The disorder causes significant discomfort or impairment in social, occupational, or other important areas of activity. For example, loss of self-esteem as a consequence of partial baldness caused by hair pulling.

Warning signs

Onset of the disorder occurs around age 13, although in some cases it may begin earlier. Often a stressful event can be associated with this pathology, such as a change of school, abuse, family conflicts, or the death of a loved one can cause anxiety and nervousness and provoke the debut of this disorder.

Some experts argue that the symptoms may be caused, or at least strongly influenced, by hormonal changes during puberty.

The most probable causes

Adolescence is a critical time to develop self-esteem, body image, self-confidence or intimacy. During this period, sufferers may be subjected to ridicule from family members, friends or classmates. But in addition, these people may experience intense feelings of guilt or shame for not being able to stop these behaviors. Even a small hairless spot can cause serious emotional problems in a person with the condition.

In many cases, people suffering from trichotillomania manage to lead a normal life: get married, have children… But in some cases, there are those who avoid intimate relationships for fear of giving away their disorder.

There is no specific cause of trichotillomania. Although some researchers believe it is possible that there is a neurochemical mismatch at the biological level at the brain level, mainly serotonin deficiency. There may also be a combination of factors such as genetic predisposition and aggravating stress or circumstances. For example, a traumatic event.

Comorbidity (co-occurring disorders)

People with trichotillomania often have symptoms of obsessive-compulsive disorder (OCD), such as counting or hand-washing. In fact, there are many similarities between trichotillomania and OCD, which is why some experts consider it a subtype of obsessive-compulsive disorder.

Depressive disorder is also often found together with trichotillomania. There may be a direct link between the neurotransmitters involved in depression and this condition (as well as OCD) because both conditions are associated with low serotonin levels. But there may also be a link between depression and low self-esteem caused by trichotillomania, since hair pulling can be demoralizing. On the other hand, hair pulling can lead to trauma causing physical and emotional pain.


According to research in the field, trichotillomania can be treated in two ways.

1. Psychotherapy

On the one hand, cognitive-behavioral therapy has been very effective. On the other hand, in some severe cases, the prescription of medication is necessary. However, the ideal is a combination of both treatments.

With cognitive behavioral therapy, patients learn to identify and manage their symptoms and employ strategies that help them improve their quality of life.

2. Pharmacology

Medications can also be effective in treating symptoms, although cognitive behavioral therapy is necessary for long-term results. Some medications (antidepressants or mood stabilizers) are used to treat this pathology: