Trichotillomania

Not to be confused with Trichomoniasis.
Trichotillomania
Other namesTrichotillosis, hair-pulling disorder, hairs-pulling disorder,[1] compulsive hair pulling
A pattern of incomplete hair loss on the scalp of a person with trichotillomania
Pronunciation
SpecialtyDermatology, psychiatry
SymptomsVisible hair loss, distress[1][2]
Usual onsetChildhood or adolescence[2]
Risk factorsFamily history, anxiety, obsessive compulsive disorder[1]
Diagnostic methodBased on symptoms, seeing broken hairs[1]
Differential diagnosisBody dysmorphic disorder[1]
TreatmentCognitive behavioral therapy, clomipramine[3]
Frequency~2%[2][3]

Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair.[2][4] A brief positive feeling may occur as hair is removed.[5] Efforts to stop pulling hair typically fail. Hair removal may occur anywhere; however, the head and around the eyes are most common. The hair pulling is to such a degree that it results in distress and hair loss can be seen.[1][2]

As of 2023, the specific cause or causes of trichotillomania are unclear. Trichotillomania is probably due to a combination of genetic and environmental factors.[6] The disorder may run in families.[7] It occurs more commonly in those with obsessive compulsive disorder (OCD). Episodes of pulling may be triggered by anxiety. People usually acknowledge that they pull their hair, and broken hairs may be seen on examination. Other conditions that may present similarly include body dysmorphic disorder; however, in that condition people remove hair to try to improve what they see as a problem in how they look.[1]

Treatment is typically with cognitive behavioral therapy.[3] The medication clomipramine may also be helpful, as will keeping fingernails clipped.[3] Trichotillomania is estimated to affect one to four percent of people.[2][3] Trichotillomania most commonly begins in childhood or adolescence.[2] Women are affected about 10 times more often than men.[1] The name was created by François Henri Hallopeau in 1889, from the Greek θρίξ, thrix (meaning 'hair'), along with τίλλειν, tíllein (meaning 'to pull'), and μανία, mania (meaning 'madness').[8]

  1. ^ a b c d e f g h American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, pp. 217–221, 938, ISBN 978-0890425558
  2. ^ a b c d e f g Franklin ME, Zagrabbe K, Benavides KL (August 2011). "Trichotillomania and its treatment: a review and recommendations". Expert Review of Neurotherapeutics. 11 (8): 1165–1174. doi:10.1586/ern.11.93. PMC 3190970. PMID 21797657.
  3. ^ a b c d e Huynh M, Gavino AC, Magid M (June 2013). "Trichotillomania". Seminars in Cutaneous Medicine and Surgery. 32 (2): 88–94. doi:10.12788/j.sder.0007. PMID 24049966.
  4. ^ Pittenger C (2017). Obsessive-compulsive Disorder: Phenomenology, Pathophysiology, and Treatment. Oxford University Press. p. 541. ISBN 9780190228163.
  5. ^ Woods D, Miltenberger R (2007). Tic Disorders, Trichotillomania, and Other Repetitive Behavior Disorders: Behavioral Approaches to Analysis and Treatment. Springer Science & Business Media. p. 134. ISBN 9780387459448.
  6. ^ "Trichotillomania (hair-pulling disorder) - Symptoms and causes". Mayo Clinic. Retrieved 2023-03-24.
  7. ^ Ramot, Yuval; Maly, Alexander; Horev, Liran; Zlotogorski, Abraham (2013). "Familial Trichotillomania in Three Generations". International Journal of Trichology. 5 (2): 86–87. doi:10.4103/0974-7753.122968. ISSN 0974-7753. PMC 3877480. PMID 24403772.
  8. ^ Aboujaoude E (2008). Compulsive Acts: A Psychiatrist's Tales of Ritual and Obsession. University of California Press. p. 42. ISBN 9780520255678.