Trichotillomania Blog

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Trichotillomania Research Update

Good old-fashioned psychotherapy remains the most effective treatment for trichotillomania. A recently published evaluation of the research suggests that pharmacological treatments lag behind behavioral and cognitive-behavioral therapies.  

The Research Says

A meta-analysis looks at all the available research conducted within a subject area to determine if broader conclusions can be made. In the case of this meta-analysis, the researchers looked for psychological and pharmacological interventions for trichotillomania used with children under age 18. Although they found 129 studies conducted, only 6 met the criteria of being a well-designed study.

Should you try alternative therapies for trich?

The reason alternative therapies are called “alternative” is that they do not have the support of the medical community or approval by the Food and Drug Administration. Does that mean they don’t work? No, it just means they have not been subjected to rigorous research, which would determine if it works as intended or does not work as intended. Before you try an alternative therapy, consider some of the following tips and suggestions.


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Trich and Comorbid Disorders

What other conditions are most closely related?

In an effort to understand the risk factors for trichotillomania, researchers continue to look for genetic links between trich and other disorders. As a member of the obsessive-compulsive disorder (OCD) diagnostic family, there are many similarities between the disorders. One of the most common reasons for misdiagnosis is that trich looks very much like OCD. This blog article from the archives offers a refresher on the differences.

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Peer Support Retreat for Trich May Be as Effective as Therapy

Treatments for trichotillomania run the gamut with cognitive-behavioral therapies such as habit reversal training and acceptance and commitment therapy ranking high for level of effectiveness. However, a study conducted in Australia presents another form of treatment modality using peer support that shows promise.

Holistic Recovery

During treatment, people with trich learn to manage behaviors, but they also work through the emotional toll of pulling. Many people with trich feel embarrassment, shame, and guilt because the disorder affects appearance, which increases social judgment. Therefore, addressing those feelings as well as anxiety, stress, depression, trauma or other mental health issues that accompany trich is an essential part of therapy. Often, social support in the form of groups or connecting with others further along in recovery gives people a boost. However, one challenge with compulsive hair pulling is its chronic, episodic nature which means a person can feel like recovery is a success and then experience a lapse.


Embrace Vulnerability

Trichotillomania is a hard thing. The multiple layers of thoughts, feelings, and behaviors can be difficult to wade through, so sometimes it’s easier to ignore it. Hide it. Hope that nobody else notices. 

However, pretending is exhausting and only reinforces shame. One Trichstop forum member described her experience as shiny and successful on the outside, “But under the surface, I felt I had no sense of self-worth or value, I felt incredibly lonely, and I was just frustrated with myself.” Rachel courageously shared her story in her post, serving as an example of the power of vulnerability that helped her recovery.

Volunteer to help with research

The TLC foundation recently posted a request for research participants aged 18 and older to participate in research studies on trichotillomania. 

The Department of Psychology at American University is currently examining symptoms, personality traits, and the triggers that lead to hair pulling. If you are an adult (at least 18 years of age) and suffer from hair pulling disorder, learn more and participate by clicking this link.  

For additional research opportunities, check out the TLC Foundation's Volunteer for Research page. 

Give Yourself a Gift for Mental Health Awareness Month

Many headlines talk about mental health awareness month with tips, tricks, gimmicks, and celebrations of recovery. These are all wonderful, but I invite you to consider giving yourself the gift of acceptance.

Problems consume

Our brains are hardwired to focus on the negative, which translates into undue attention paid to whatever problem we encounter. This problem could be health, life, or mental health related, the brain is not picky, but the problem tends to become the focus of our thoughts and feelings until it feels like our whole world experience centers on the issue. People who struggle with trichotillomania tend to focus on the problem of hair pulling, and when they are not focused on the problem, they are focused on hiding the problem or fearing that others will notice the problem causing more difficulties of embarrassment and shame for them. The problem then consumes the person’s life, and all one can see is the problem which often leads to the problem becoming central to one’s identity. You feel most that which becomes your point of focus.

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Update: N-acetylcysteine (NAC)

A previous blog post talked about the potential benefits of N-acetylcysteine (NAC) for trichotillomania, citing a Minnesota study that showed over half of the participants showed reduced hair pulling when using it. A more recent review of the research discussed NAC and its effectiveness for various mental health disorders.

More details about how it works

NAC is an amino acid historically used as a mucolytic and for treatment of acetaminophen overdose. A mucolytic dissolves thick mucus in the respiratory system. It essentially dissolves the chemical bonds that holds the thick secretions together. A common version of a mucolytic is Mucinex which is made with guaifenesin. However, NAC’s mucolytic properties are not the focus of this blog post, but it does provide an indication of how long NAC has been used in medicine.

Sold as a nutritional supplement over the counter, NAC is often marketed as an antioxidant that can improve brain functioning. Without going in-depth about neuroscience, NAC


Online Test for Trichotillomania

Find Out The Severity of Your Hair Pulling With This Free Online Test