Hair-Pulling Disorder (Trichotillomania)

Hair-pulling disorder refers to the pulling out of one's hair, resulting in hair loss. Individuals with hair-pulling disorder describe that the repetitive hair pulling produces feelings of pleasure or relief in the moment, but feelings of distress and even shame later. Despite repeated attempts to decrease or stop pulling, the person is unable to do so. Hair may be pulled from their scalp, eyelashes, eyebrows, or other parts of the body, often leading to noticeable bald patches. Roughly 1% to 2% of the general population suffers from hair-pulling disorder, and females are 10 times more likely to be affected than males. Over time, hair-pulling disorder and the associated hair loss can significantly interfere with a person's functioning and happiness.

Hair pulling may be accompanied by a range of behaviors or rituals involving hair including searching for a particular kind of hair to pull, pulling the hair out in a specific way, visually examining, and/or touching or orally manipulating the hair after it has been pulled. Some individuals may eat the hair, resulting in potentially significant gastrointestinal problems. Hair pulling may be preceded or accompanied by various emotional states and may involve conscious awareness of the behavior or be done by individuals more "automatically." Individuals with hair-pulling disorder may experience embarrassment, feelings of loss of control, and shame as a result of their pulling. They may avoid work, or other public situations due to these negative feelings.

Key Symptoms of Hair-Pulling Disorder

• Recurrent pulling out of one's hair, resulting in hair loss
• Repeated attempts to decrease or stop hair pulling
• The hair pulling causes significant distress or impairment at work/school, with peers, and with family
• Hair loss is not attributed to another medical condition