What Causes Compulsive Hair Pulling?

Jun 22nd, 2018

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Trichotillomania is a disorder in which a person has a compulsive urge to pull out his or her own hair. Occasionally, this is accompanied by the urge to eat the hair one it is pulled out. Obviously, trichotillomania causes a crippling effect on a person’s life from both a social and a functional standpoint – it may be tough to participate in the day to day functions of life like hanging with friends or even holding down steady employment if a person has a reputation for chronic hair-pulling. As such, there is great interest in gaining a better understanding in trichotillomania and break down the ins and outs of the disorder so that people that suffer from it can have the ability to live normal lives. And one of the biggest focuses in this regard is to try and figure out what causes trichotillomania.

Not Completely Known

From a biological standpoint, it is unknown as to what causes hair pulling. There is research that is being devoted into discovering the root biology that may lie behind the disorder, but studies devoted to finding biology-based trichotillomania causes is still in its relative infancy. That being said, science is not completely in the dark regarding the disorder and its possible causes. For example, there has been evidence mined that suggests that it is a neuro-biological disorder and that it could be linked to genetics.

To that end, most of what has been theorized about what causes trichotillomania does come from the neurological side of things. Indeed, there are several neuro-based theories that are floating about that could be considered triggers for the disorder. Some of the more prominent theories include:

  • Simple sensory events – It has been theorized that a basic sensory-related episode that most of us take for granted, such as an itchy eyelash, may be the first firing shot of trichotillomania’s onset.
  • A stressful life event – It has been generally accepted that trichotillomania is utilized by its sufferers as a self-soothing mechanism to help cope with times of high stress or anxiety. By that extension, it is theorized that the onset of what causes hair pulling could very well be triggered by a particularly stressful life event.
  • A manifestation of Obsessive Compulsive Disorder (OCD) – Because trichotillomania is considered to be a compulsory action, some experts feel that the disorder is closely linked to an overarching OCD issue. What’s more, because OCD has been thought to be linked to a chemical imbalance within the brain as brought on by various environmental and biological factors, it has been theorized that trichotillomania causes are also rooted in this lack of chemical balance.

Biological Theories

It should be noted that while the biological aspects of trichotillomania have not necessarily been pinpointed, there are several theories as to where the disorder may stem biologically.

One of the more prominent theories ties trichotillomania to changes in a person’s hormone levels. On paper, this theory tends to make a great deal of sense. After all, trichotillomania’s peak age of manifestation is around 11 years old; an age that tends to correlate to a young person’s entrance into puberty and all of the hormonal-based shifting that results from this progression into adolescence. Because emotion, mood, and anxiety-related elements that are tied to this significant change are heightened, trichotillomania would manifest itself as a self-soothing mechanism.

Another biological theory has to do with a possible lack of serotonin in the brain of people who suffer from the disorder. Serotonin is in essence the chemical that the brain produces to “feel good” as opposed to feeling stressed out or depressed. There seems to be something to this theory: People that have been diagnosed with trichotillomania have received treatment with a substance that boosts serotonin levels and have yielded positive results.

A third theory may not be considered as much of a theory as it is a correlation. Brain scans on some people with trichotillomania have yielded various kinds of brain abnormalities. That being said, it should be noted that such abnormalities were only present in some cases of trichotillomania; as such, it should be assumed a person that is suffering from the disorder does not automatically have a brain abnormality.

Classifying Trichotillomania

What causes hair pulling is not the only thing that is up for debate in terms of trichotillomania. There also is much discussion regarding how exactly the disorder should be classified.

One of the potential classifications on the table is one that simply labels it as a form of OCD. This is spurred on by the compulsory nature of trichotillomania. While there can be a case made to link the disorder with OCD – and it is a strong case, since trichotillomania does have characteristics that seem consistent with other OCD-related issues – some feel that this association should be less of a correlation and more of a singular example that falls under the OCD umbrella.

Another potential classification has to do with labeling trichotillomania as a form of self-harm; a condition that is marked by a person deliberately injuring himself or herself in order to receive temporary relief from emotional distress. The pain that correlates with this type of condition releases endorphins, which in turn cause a temporary sense of well-being. This would put trichotillomania into other well-known issues that relate to self-harm, such as cutting – an issue that, like trichotillomania, tends to peak at an early age. This theory does especially tie into the notion that trichotillomania may manifest itself as a means to cope with a heightened traumatic experience.

The Necessity of Treatment

In the end, the matter of what causes trichotillomania is not as important as figuring out a way to prevent its effects. Indeed, it has the potential to be a devastating disorder, regardless if its roots are from a chemical imbalance or high emotional trauma. Because of this, the notion of finding a consistent treatment for trichotillomania is something that is on the forefront of scientific research related to this disorder, and it will be until a consistent treatment is established.


TrichStop’s editorial team is comprised of mental health professionals who specialize in research and treatment of BFRBs (body focused repetitive behaviors) such as trichotillomania (hair pulling) disorder. You can learn more about our team here.

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