Trichotillomania Blog

Hair Loss and Trichotillomania

People who have trichotillomania have an irresistible urge to pull out their hair, usually from their scalp, eyelashes, and eyebrows, but any part of the body where hair grows can be a target. Trichotillomania is a type of impulse control disorder. People with these disorders know that they can do damage by acting on the impulses, but they cannot stop themselves. They may pull out their hair when they're stressed as a way to try to soothe themselves. The exact cause of trichotillomania isn't known. It may be related to abnormalities in brain pathways that link areas involved in emotional regulation, movement, habit formation, and impulse control. Some people with trichotillomania may also have depression or anxiety.

What Desperate Measures have you Taken?

A recent MailOnline article described the story of Eden Cahill, a 15-year-old teenager with trichotillomania, who shaved her whole head to beat the urge to pull. Eden suffered through most of her childhood with trichotillomania causing her to have large bald patches that she tried to hide by wearing thick headbands and hats at all times. Eden also used to hide in the school bathrooms for fear of ridicule. However as a teenager Eden decided to tackle her trichotillomania head on. Inspired by Sam Faiers, a star from the popular British reality show 'The Only Way is Essex', who revealed in 2012 that she was afflicted by this condition too;

Trichotillomania and Body Dysmorphic Disorder

Trichotillomania, also known as Compulsive Hair Pulling disorder, was only first recognized as a clinical disorder by the American Psychiatric Association (APA) in 1987 when it was included in Diagnostic and Statistical Manual (DSM-III Revised edition). Since then the diagnostic criteria for trichotillomania has been revised to the current version found in the DSM-5. The DSM-5 characterizes trichotillomania by recurrent repetitive behaviour (hair pulling) and repeated attempts to decrease or stop the behaviour. The behaviour can occur during both relaxed and stressful times, but there is often a mounting sense of tension before hair pulling occurs or when attempts are made to resist the behaviour.

Trichotillomania and Impulse Control Disorder

Trichotillomania or compulsive hair pulling disorder was the first of the body-focussed repetitive behaviours (BFRBs) to be recognized as a clinical condition by the American psychiatric Association(APA) in 1987, when it was included in the Diagnostic and Statistical Manual (DSM). Prior to the latest revision of the DSM, trichotillomania was classified in the DSM-IV-TR as an impulse control disorder (not elsewhere classified) along with four other impulse control disorders namely: kleptomania, pyromania, intermittent explosive disorder, and pathological gambling. However in 2013 trichotillomania was moved to be classified under obsessive compulsive related disorders in the DSM5.

Trichotillomania: Pulling Nose Hairs

Pulling out one's nose hairs in not an uncommon practice and is in fact a acceptable grooming practice, particularly among men. However, what happens when the act of pulling at a nose hair goes beyond being motivated by aesthetics and the person finds themselves compulsively pulling the nose hairs throughout the day? This could be a form of trichotillomania. Trichotillomania is characterised by feelings of an overwhelming urge to pull at hairs on the body. The site for pulling varies from person to person, commonly the scalp, the arms and legs or the face. Compulsive hair pulling can be so severe that it causes balding or hair thinning. Although not as common as other sites for pulling, plucking nose hairs can also be a focus area for some people.

Keeping Trich Hair Healthy

Compulsive hair pulling can lead to baldness or hair thinning, which has a negative impact on an individual's self esteem. This is particularly true for woman who are expected to match societal expectations of having a full head of beautiful hair. Many trichotillomania sufferers find that the disorder leads to them socially isolating themselves due to the shame and guilt associated with the behaviour, and the embarassment about the appearance of balding spots. In addition to this, the lack of awareness of compulsive hair pulling as a clinical condition means that most people do not seek help or support and therefore struggle with this condition on their own. However there is hope for those with trichotillomania, with a variety of treatment options available.

Take Part in a Clinical Study

Trichotillomania is often a misunderstood mental health condition. This is because many people are too embarrassed to seek professional opinion about something they assume to be just a bad habit. Fortunately, thanks to the awareness raising efforts of organisations such as the Trichotillomania Leaning Centre (TLC), the disorder has recently enjoyed increased attention from the medical and research fraternity. More and more research studies are being conducted to understand the causes and effects of the disorder and to develop treatement options. Hence it is important to contribute to the studies by becoming a participant and sharing your experience of trichotillomania.

Hair Twirling and Trichotillomania

Hair twirling may seem to be a harmless habit, but there is a real risk that it can develop into something more serious. It is not uncommon for people to sub-consciously engage in repetitive behaviours such as foot tapping, shaking the legs or hair twirling in response to stress, anxiety or even tiredness. According to sensory integration theory these behaviours serve to soothe excessive or elicit dampened sensory stimuli.  While for most people this will never be more than a habitual response, for some this can signal the beginning of compulsive hair pulling disorder.

Habit Reversal Training for Trichotillomania

The habit of pulling ones hair when bored, tired, or deep in thought is not an uncommon one and just because you pull your hair does not necessarily indicate the presence of a disorder. But according to the Diagnostic and Statistical Manual (DSM5) a diagnosis for trichotillomania or compulsive hair pulling disorder should be considered when the person is unable to stop engaging in the behaviour despite it causing visible hair loss and balding, and functional impairment is evident as a result of the behaviour. This indicates that a bad habit has evolved into a clinical condition and therefore treatment is required.

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