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Trichotillomania



What is Trichotillomania?

Trichotillomania is a compulsive hair pulling disorder. Those affected by it will pull hair from the scalp, eyebrows and other body areas. This results in bald patches on the scalp, face and other areas of the body.

What is the cause of Trichotillomania?

Trichotillomania is felt to represent a version of an obsessive compulsive disorder with patients being unable to stop pulling their hair.

What are the symptoms?

Symptoms of Trichotillomania can include pulling, biting, or chewing on hair. Pulling out the eyebrows and eyelashes also happens. Emotional gratification ranges from excitement to relief when the hair is pulled out.

How is it diagnosed?

A dermatologist can notice visual signs on examination of the scalp that are suggestive of trichotillomania. When questioned about a history of hair pulling, some individuals will openly admit to the behavior and others will deny it.

What tests are needed?

At times a skin biopsy of the scalp will be performed to check for any underlying medical disorders of the scalp that could be associated with or triggering the hair pulling behavior.

What is the expected duration?

The duration is determined by how severe the symptoms are and can continue for years.

How can it be prevented?

There is no known prevention.

Treatment

Hair loss and scalp inflammation due to trichotillomania are treated with antibiotics, topical and intralesional steroid injections. Behavior modification is required to get a person to stop pulling the hair and some individuals can do this on their own. For those in denial and won’t admit to the condition, psychotherapy could be required to reverse the pulling habit.

When to contact a professional

A dermatologist should be immediately consulted when hair pulling causes hair loss occurs and the patient does not feel in control of their actions.

Prognosis

Successful treatment can take a time. Denial of the hair pulling is a barrier to successful resolution of the condition. Determining if there is an underlying cause can take persistence and care sometimes for years.

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