They say for every problem, there’s a solution. Well, that might be true, but it depends on how you define the solution. When you’re looking for answers to a problem, there’s no shortage of recommendations, stories, and downright fantastical tales of overnight cures. A quick spin around the internet will yield thousands of promises, cures, and magical treatments all promising relief for BFRBs like hairpulling and skin picking. Some of them even sound plausible. It’s tempting to latch on to whatever “sounds” good. The problem is, how do you know if it actually is helpful?

If you struggle with a BFRB, you’ve no doubt done your share of searching for relief. In your search for treatment, you’ve probably come across the term “evidence-based treatment” or EBT. It sounds good, right? But what does “evidence-based” really mean? More importantly, what does EBT mean for people living with BFRBs?

The answers lie in science.

In a recent TrichStop.com webinar, Dr. Vladimir Miletic tackled the topic of hair-pulling “trances”. While this behavior is something we know happens, there is surprisingly little literature on this phenomenon. Much of what we know about trance pulling comes from anecdotal evidence. In other words, people report doing it and talk about it. So, just what do we know about trances? Turns out, quite a bit.

Defining A Hair Pulling Trance

A hair-pulling trance is a prolonged episode of hair-pulling that is all-engaging. The person becomes intently focused and completely absorbed in the experience of pulling. They may be completely unaware of what’s happening around them and they might not even be aware that they’re pulling. As a result, the use of competing responses is rather ineffective because they’re not going to attend to it. The focus of the trance is pulling.

While trichotillomania (TTM) can occur at any age, the onset is most often seen in children ages 10-13, and more common among females. Some studies suggest that it’s not uncommon to seek out a dermatologist for treatment. After all, trichotillomania and skin picking present with distinct dermatological issues. But, these disorders also have distinct psychological underpinnings that perpetuate the behavior that creates skin and hair issues. Other studies suggest that people tend to seek out mental health support. Determining who to see and when isn’t always clear. So, the logical question one might ask is, “Do I need a psychiatrist or a dermatologist?” When it comes to body-focused repetitive behaviors (BFRBs) and some other skin disorders, the answer seems to be both.

Trichotillomania, also known as hair-pulling disorder (HPD), could be more common than originally thought. In fact, approximately 2% of the general population struggles with HPD at any given time. But, because HPD sufferers tend to be ashamed of their behaviors, many do not seek treatment, leaving many cases unreported.