A woman with no top is looking to the side with most of her face covered by hair.

The Troubles and Treatments of Trichotillomania

Have you ever wondered why that person over there can’t seem to stop pulling at their eyebrows?

They don’t seem to be in pain or anything. But pulling out hair doesn’t seem like a typical reaction. Isn’t that a form of self-harm? Should you intervene?

Well, before you go over there and interrupt someone’s day, you might want to consider that this person might have trichotillomania. It’s a hair-pulling disorder that compels people to pull hair from their scalp, eyebrows, or other areas. This can leave obvious bald patches and cause significant distress as these people try to disguise their hair loss. However, in some cases, it’s quite a mild and manageable condition. Not all cases are so lucky, unfortunately.

Either way, though, it is more damaging to go up to a person with this condition and confront them about it. Doing so can make that person feel judged, which could lead them to avoid seeking help for fear of further judgment.

If you want to help someone with trichotillomania, you’re better off learning about the condition first. Luckily, this article is here to guide you on some of the basic facts surrounding trichotillomania and its troubles and treatments.

Trichotillomania can be a serious source of discomfort for sufferers.

An adult is hugging their knees on leaf-covered ground next to a brick building.

The first thing to keep in mind is that trichotillomania can be extremely distressing for those who have it. While some can live with their condition, others are overwhelmed by the loss of the hair and its impact on their lives. And despite their feelings, they’ll still have a strong urge to pull out their hair. So even as they try to disguise bald patches on their scalp with a hat or cover missing spots in their eyebrows with makeup, their situation will still worsen and increase their stress. In turn, they’ll have an even harder time being able to socialize with others due to the self-consciousness that trichotillomania promotes.

But why then does this condition make hairpulling so compelling?

For some people, trichotillomania offers them a way to relieve any tension, stress, or negative emotions they feel. It seems contradictory considering how much stress hair loss can cause. But even so, satisfying their desire to pull out hair can give them a great sense of relief.

For others, trichotillomania is just something they do automatically. So they might start pulling hair without even realizing it while they’re bored, reading, or watching television.

Other symptoms they might encounter include:

  • Getting increased tension before pulling out hair or resisting the urge to pull
  • Feeling pleasure or relief once the hair has been pulled
  • Having visible hair loss
  • Preferring some types of hair over others
  • Applying ritualistic hair-pulling methods or patterns
  • Wanting to bite, chew, or eat any pulled-out hair
  • Playing with the pulled-out hair
  • Rubbing the pulled-out hair across lips or face
  • Attempting to stop pulling out hair with little success
  • Dealing with significant distress over the hair pulling

All of which can add up to a seriously mixed bag of frustration for sufferers.

Many people misunderstand the cause of the condition.

A blonde-haired woman in a blue shirt with white spots has her hand on her forehead in a gesture of frustration.

It doesn’t help either that the general public doesn’t really understand what causes trichotillomania. As a result, there are a few myths out there that need to be dispelled.

Despite some seeming similarities, trichotillomania is not a sign of an obsessive-compulsive disorder.

It’s true that trichotillomania does look similar to obsessive-compulsive disorder (OCD). After all, the two conditions involve repeated, compelling behaviors. But according to The TLC Foundation for Body-Focused Repetitive Behaviors, trichotillomania and OCD both have enough differences to indicate that they are not one and the same. And because of that, trichotillomania is classified under the obsessive-compulsive and related disorders category in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Likewise, trichotillomania should not be viewed as a form of self-mutilation.

Because a significant loss of hair can be seen as distressing, trichotillomania can look like a form of self-mutilation. But it’s not. Self-mutilation is when people try to harm, punish, or distract themselves from emotions they aren’t able to tolerate. In contrast, those who engage in trichotillomania pull hair to feel positive sensations, such as stress relief or gratification—even if the end result is distressing.

Lastly, the condition can be seen as a sign of some hidden trauma, but it shouldn’t be viewed like that in general.

Much like how many can mistake the stress behind trichotillomania as self-mutilation, others might view it as some sort of unresolved issue that needs to be addressed. But in general, that doesn’t seem to be the case. Recent knowledge of trichotillomania has indicated that the condition is not usually a sign of hidden trauma.

So, what does cause it?

A bright neon question mark is surrounded by an equally bright neon square in a grimy hallway.

So, you know now what doesn’t cause trichotillomania. But what is the cause?

Genetic Predispositions

In some cases, the cause of trichotillomania can be a genetic predisposition for body-focused repetitive behaviors (BFRBs). The TLC Foundation for Body-Focused Repetitive Behaviors notes, several studies indicate that a great percentage of people with BFRBs have immediate family members with the same issue. One study even showed how hairpulling can equally affect identical and fraternal twins.

Other Related Factors

But a genetic predisposition is just one potential cause of trichotillomania. There are other factors that may be involved as well, such as:

  • Temperament
  • Environment
  • Age of onset
  • Family stress

How can trichotillomania be treated?

No matter the cause, there are a few ways people can treat their trichotillomania.

Medication

To help minimize the desire to pick or pull at hair, health-care professionals may prescribe medication. While the medication won’t treat trichotillomania itself, it can help people with the condition get through therapy that might otherwise have made them feel too uncomfortable. It can even treat other psychiatric conditions that they may be suffering from like depression.

It can be an expensive minimal treatment, however. After all, Americans pay more for prescription medications compared to most other countries. But there is a way around this expense, though. For instance, international and Canadian pharmacy referral sites like Canada Med Pharmacy ship medication from licensed pharmacies outside of the United States for a much cheaper price than what can be found at the local brick-and-mortar pharmacy.

Cognitive-Behavioral Therapy

The most important and effective treatment to look at, however, is cognitive-behavioral therapy (CBT). This treatment helps patients address their thoughts, feelings, and behaviors in a way that gives them a stronger sense of control over their hairpulling. What’s more, this treatment can involve a technique called habit reversal training, which can help combat the strong compulsion for hairpulling that trichotillomania creates.

But don’t forget that these treatments will only help someone with trichotillomania if they feel ready to be treated. So try not to make them feel ashamed. They need all the encouragement they can get because they’re already doing their best to fight themselves and their condition.