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Trichotillomania (Hair Pulling)

Trichotillomania, also known as hair-pulling disorder, is characterized by the recurrent and compulsive urge to pull out one's hair, leading to noticeable hair loss and significant distress.

What is Trichotillomania (Hair Pulling)?

Trichotillomania, also known as hair-pulling disorder, is characterized by the recurrent and compulsive urge to pull out one’s hair, leading to noticeable hair loss and significant distress. Though it predominantly manifests in the scalp, individuals may engage in hair pulling from any body area, including eyelashes and eyebrows. The term is derived from Greek words: “thrix” meaning hair, “tillein” meaning to pull, and “mania” indicating an intense preoccupation or obsession.

Individuals with trichotillomania often find temporary relief or gratification from the act of hair pulling, but this is typically followed by remorse or distress.

The onset of trichotillomania can occur at various ages, but it often begins in late childhood or adolescence. The specific triggers for hair pulling can vary among individuals, with stress, anxiety, or boredom commonly cited as contributing factors. It can manifest in different forms, such as pulling hair from the scalp, eyebrows, eyelashes, or other body areas, and its severity ranges from mild to severe, with some individuals experiencing only occasional pulling while others engage in chronic and extensive hair removal.

For some people, trichotillomania can be automatic, and they pull out hair without realizing that they’re doing it (for example, while reading), while others can purposely pull out hair as a ritual to relieve tension. The repetitive nature of the behavior can lead to a cycle of distress and impairment in daily functioning.

Treatment for Trichotillomania (Hair Pulling)

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) empowers you to identify and change the thoughts and behaviors contributing to trichotillomania. In a supportive and collaborative environment, our experienced therapists help you obtain freedom from trichotillomania.

Building Coping Strategies: Through CBT, we work together to build a toolkit of practical strategies. This includes recognizing triggers, challenging negative thoughts, and finding alternative behaviors to replace hair pulling.

Empowering Change: CBT isn’t just about managing symptoms – it’s about reclaiming control over your life. By fostering self-awareness and providing effective tools, we empower you to break free from the cycle of trichotillomania.


Medication can play a supportive role in managing symptoms and enhancing the effectiveness of CBT for trichotillomania.

  1. Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs are commonly prescribed to address underlying mood and anxiety issues associated with trichotillomania. 
  2. N-acetylcysteine (NAC): NAC is a promising supplement that has shown effectiveness in reducing hair-pulling symptoms. It is believed to work by modulating glutamate levels in the brain, affecting the impulsive behaviors associated with trichotillomania.

Integrating CBT + Medication

Our approach involves a careful integration of CBT and medication, depending on patient preferences and clinical need, to address both the biological and psychological aspects of trichotillomania.

  1. Collaborative Treatment Planning: Our experienced team works collaboratively to create an individualized treatment plan that assists you in meeting your treatment goals as effectively and rapidly as possible.  
  2. Patient Empowerment: We believe in empowering you with comprehensive information about trichotillomania treatment options, allowing you to make informed decisions about your treatment journey. 
  3. Monitoring Progress: Regular monitoring and adjustments to your treatment plan are made based on your response and progress. This ensures you are obtaining maximum benefits from the time and energy you are putting into the trichotillomania treatment process.  
  4. Ongoing Support:  We offer ongoing support and adjustments to your treatment plan as needed, ensuring a comprehensive and personalized approach to your path to healing.

Your Unique Path to Freedom From Trichotillomania

Our goal is to create a treatment plan that aligns with your needs and preferences, recognizing that each individual’s journey is unique.

What are the symptoms of Trichotillomania (Hair Pulling)?

Trichotillomania manifests through a distinctive set of symptoms that revolve around recurrent hair-pulling behaviors, impacting both the physical and psychological well-being of affected individuals. This compulsive disorder involves a spectrum of symptoms:

The defining characteristic of trichotillomania is the recurrent urge to pull out one’s hair. This behavior often occurs in response to boredom, tension, anxiety, or as an automatic response to stressors, becoming a ritualistic coping mechanism.

Continuous hair-pulling results in noticeable hair loss, leading to visible bald patches on the scalp, eyebrows, eyelashes, or other body areas with terminal hair. Individuals may go to great lengths to conceal the hair loss, such as wearing hats or wigs, further contributing to the distress associated with the disorder.

Individuals with trichotillomania experience a sense of relief or gratification during or after the hair-pulling episode. This positive reinforcement reinforces the compulsive behavior, perpetuating the cycle of hair-pulling despite awareness of its detrimental effects.

Many individuals with trichotillomania make repeated efforts to control or stop the hair-pulling behavior but often find it challenging to maintain sustained periods of abstinence.

Trichotillomania is associated with a range of emotional responses, including anxiety, guilt, and shame. The emotional toll of the disorder can significantly impact social and occupational functioning, leading to isolation and diminished self-esteem.

Chronic hair-pulling can result in physical consequences such as skin irritation, infections, or repetitive stress injuries. Individuals may also experience gastrointestinal distress or other somatic symptoms related to the emotional distress associated with the disorder.

FAQs about Trichotillomania (Hair Pulling)

There is evidence suggesting a genetic component to trichotillomania, as it can run in families. However, environmental factors also play a role in its development.  

There’s a potential link between ADHD (Attention Deficit Hyperactivity Disorder) and Trichotillomania, as both conditions involve difficulties with impulse control. However, individual experiences vary, and not everyone with ADHD develops Trichotillomania.

Yes, in many cases, hair can grow back after trichotillomania if the pulling behavior is successfully managed or treated. However, regrowth may take time, and individual experiences can vary.

Are you ready to take the first step?

Reach out to us, and let’s work together to bring about positive change.

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