Stop Hair Loss Due to the Hair-Pulling Disorder Trichotillomania

Edited by Donna, Eng, Doug Collins, DeleteQnA


Hair pulling disorder is also known as Trichotillomania. It qualifies as a chronic obsessive-compulsive disorder that compels an individual to constantly pull out hairs from the head, eyebrows, arms, legs or any other part of the body. Sufferers of this disorder become so anxious that they literally "tear their hair out" which results in patchy bald spots.

Compulsive hair pulling is a cause of premature balding.

Symptoms of Trichotillomania

The symptoms of hair pulling disorder include:

  • Being unable to stop pulling your own hair out, no matter how much you try and control the compulsion not to
  • Feeling nervous, tense and upset if you do not pull out your hair all of the time
  • Feeling relieved, pleased and even ecstatic after the hair is pulled
  • Ritualizing the hair pulling, as in always pulling it out from the same place or pulling it out so that bald patches are in a specific pattern
  • Bald patches on the scalp
  • Sucking on, chewing on or eating the pulled-out hair
  • Pulling out hair and then rubbing it on the face
  • Fiddling with pulled out hair strands
  • Arranging a private time so that one can pull out their hair in secret

Sufferers may want to stop fiddling with their hair but they can't stop.

Aside from partial or even massive permanent hair loss people who suffer from trichotillomania may also experience these long term consequences:

  • Avoidance of the hairdresser so that your secret hair-pulling or bald patches can't be discovered
  • Blood on the pillow from bleeding hair follicles
  • Biting or chewing nails is a symptom that can be concurrent with the hair-pulling symptom
People who compulsively pull their hair out may also be chronic nail-biters.
  • Constant criticism from friends who family who cannot comprehend the disorder and think that you are persisting in it to hurt them
  • Depression and anxiety due to not being able to control oneself
  • Embarrassment in social situations or avoidance of social situations
  • Feelings of shame
  • Fungal infections in the areas of the scalp where the hair is pulled
  • Inflammation of the hair follicles
  • Ingesting hair can lead to the development of hairballs that cause vomiting and weight loss and that must be removed from the digestive tract surgically
  • Scratching compulsively is another symptom that can be concurrent with the hair-pulling symptom

Biting, sucking and twiddling with the ends of hair are a symptom of trichotillomania.

Causes of Trichotillomania

The causes of hair-pulling disorder are still unclear because it is such a complex psychiatric disorder but it is thought to be the result of:

  • Anxiety
  • Childhood trauma
  • Depression
  • Excessive Stress, especially emotional stress

Excessive stress is a cause of chronic obsessive hair pulling.

  • Fatigue
  • Frustration
  • An imbalance of brain chemicals, especially serotonin and dopamine
  • Low self-esteem
  • Medication side-effects that cause obsessive behavior
  • Post-traumatic stress disorder

Emotional problems are associated with this type of hair loss.

Steps To Stopping Hair Loss to Hair Pulling Disorder

Although it may seem obvious that the solution to stopping and preventing hair loss from Trichotillomania is to simply stop pulling out your hair, the disorder is more complex than that. In this case you will not only be treating the inflammation and hair loss associated with the disorder, you will also be seeking help for the underlying cause.

Here are the steps to stopping and reversing hair loss due to trichotillomania:

  1. 1
    Admit you have a problem and that you are addicted to pulling your hair out
    Like any addict this is a habit that you are unable to stop and the first step to dealing with it is to admit that you are doing it every day. This is the type of disorder where the sufferer often remains in denial until it is too late to get to the bottom of what caused the compulsion in the first place. Be prepared to get to work on this problem by following the steps outlined below.
    Making lists that describe your current psychological state, general health and medications that you are on can help your doctor prescribe you the proper treatment for your hair loss disorder.
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  2. 2
    Make a list of all the medications that you take on a daily basis
    Anxiety or obsessive behaviour. can be a side effect of many drugs, both prescription and non-prescription. This is one of four lists you will be taking to your doctor to try and figure out why you feel so stressed that you are literally pulling your hair out. If this is not your usual doctor be sure to inform him of any medical or psychiatric conditions that you are currently being treated for.
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  3. 3
    Make a list of all of the vitamins and herbal supplements you may be taken
    Some herbal supplements have an impact on hormones or mental function in ways that could be affecting your behaviour.
    Be sure to mention all of the supplements and vitamins that you are on to your doctor.
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  4. 4
    Make a list of all of the physical symptoms that you are feeling when you pull your hair
    Some people feel nauseous, shaky or have stomach pain, which are all symptoms associated with anxiety disorders. Write out everything that you experience, even if it seems unrelated, as it can help your doctor diagnose any underlying condition that might be causing the issue
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  5. 5
    Make a list of all of the psychological symptoms that you feel when you pull your hair out
    How do you feel just before you pull your hair out? Do you cry? Feel frustrated? Feel numb or nothing at all? Also document how you feel after you have pulled your hair all out.
    The urge to pull your hair out is typically about ritualizing emotional pain.
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  6. 6
    Ask your doctor for help
    Make an appointment to see your doctor and be sure to follow through by showing up to discuss the issue. Bring your lists with you so he can help the both of you find a solution for your hair-pulling problem. Do not worry that your doctor may not be familiar with the disorder. It is more common than you think and he or she will want to get you the help you need. Do not let a fear of being misunderstood prevent you from getting help.
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  7. 7
    You will be required to follow up with both medical and psychiatric testing as recommended by your doctor
    Depending on what your doctor says you may be prescribed psychiatric drugs, lifestyle changes and cognitive therapy to deal with your issue.
    Your doctor can help you take your own hair pulling disorder seriously so it can be treated.
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Medications Commonly Prescribed for Trichochotillomania

Your doctor or psychiatrist may prescribe the following medications to treat your condition:

  • Antidepressants to treat the mood disorder associated with obsessive-compulsive disorders.
  • Antipsychotics that help regulate mood and dispel anxiety
  • Acetyl cysteine, an amino acid that helps elevate mood and prevent the anxiety that causes hair pulling

Psychotherapy Treatment for Stopping Hair-Pulling Disorder

Most commonly psychotherapy is prescribe either alone or as a support for prescribe medications. These include:

  • Habit Reversal Training which, with the help of a therapist, helps the sufferer recognize situations that trigger anxiety and the reaction of hair-pulling
  • Cognitive Therapy that helps you reconsider your beliefs and perceptions about why it is necessary to pull your hair
  • Commitment Therapy, which teaches you to feel your feelings without acting on them and achieve some self-control when faced with a situation that makes you want to tug on your hair or chew it
  • Supportive Group therapy, in which the sufferer of trichotillomania gets to talk with others who have the same disorder in order to understand it and stop the behavior

Psychotherapy might be described for those who cannot deal with their feelings about life and resort to tugging and pulling on their hair.

Lifestyle Changes That Stop Trichochotillomania

Lifestyle changes that allay anxiety are recommended for those who compulsively pull their hair out are:

  • Avoiding hairdressers until your doctor, therapist or psychiatrist says it is okay to do so as the manipulation of your hair may trigger urges to pull your hair
  • Avoiding styling or putting your hair up in a bun or ponytail as this can trigger hair pulling
  • Avoiding solutions to your hair such as Rogaine, hair dye or hair straighteners until your doctor says it is fine to do so as simply applying these solutions can trigger the impulse to start plucking hairs out
  • You might want to consider shaving your head to avoid being tempted to pluck out your hair until you have completed your course of medication or therapy

Shaving your head might help prevent you from pulling your hair out.

  • Taking long walks or go for a long bike ride every day to help allay your stress levels
  • Practicing guided meditation with deep breathing every morning and night to help reduce anxiety and stress
  • Avoiding situations and people that are causing you so much pain that you are literally plucking your hair out; for some people this can mean leaving a relationship or a job.
  • Eating foods that are rich in iron, biotin, omega 3 acids and protein. These are the building blocks of a healthy scalp and lustrous locks. Consume eggs, red meat, shellfish, whole grains, coconut oil, olive oil, avocados and fresh leafy greens

Be prepared to love eating red meat as it helps regrow hair.

Tips and Tricks

  • Home remedies of baldness are not recommended for people with this disorder because the sight of their own bald patches can trigger additional episodes of plucking out their own hair; follow the guidance of your doctor as to when you might be ready to try hair regrowth or hair replacement solutions.
  • Some people who suffer from hair-pulling disorder may not be aware that they are doing it and may tug at their strands while watching television or when they are bored
  • If you start tugging at your strands, notice what is on your mind or stressing you out at the moment, to get to the bottom of why you indulge in Trichotillomania and to see if you can remove yourself from the source of stress
    Removing yourself from sources of stress can help you recover from hair-pulling disorder.
  • This is a disorder that can go on for weeks, or even years without being diagnosed until the person has actually caused so much damage to the scalp that she is actually balding
  • More women then men seem to be affected by the disorder, but that might be because women are more likely to go to the doctor and seek help for it because it can be so hard on the appearance

Questions and Answers

If you have problems with any of the steps in this article, please ask a question for more help, or post in the comments section below.


Article Info

Categories : Hair Loss | Hair Care And Treatment

Recent edits by: Doug Collins, Eng, Donna

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