I Want to Pull My Hair Out!

We’ve all said this once or twice, as an illustration of being frustrated or stressed out. Little do many people know that this is something that 4% of the U.S. population will struggle within their lifetime.

Ever Heard of Trichotillomania?

Trichotillomania (trick-o-til-o-MAY-nee-ah) , also referred to as TTM or “trich”, is a disorder that causes people to pull out the hair from their scalp, eyelashes, eyebrows, pubic area, underarms, beard, chest, legs or other parts of the body, resulting in noticeable bald patches. Hair pulling varies greatly in its severity, location on the body, and response to treatment. TTM has a similar resemblance to Obsessive-Compulsive Disorder; in the feelings of compulsion and repetitive behavior.

The onset of TTM is usually between the ages of 11 and 13, but it can start as early as infancy. Males and females are equally impacted in childhood, but by adulthood 80% to 90% of reported cases are women. The pulling behavior serves as a coping mechanism for anxiety and other difficult emotions. It does not hurt and they are not trying to damage themselves.

TTM is part of a group of behaviors called Body-Focused Repetitive Behaviors (BRFB’s), in which an individual damages his or her appearance or causes physical injury. Two out of 50 people suffer from hair pulling disorder.

Other examples of BRFB’s are:

  • Skin picking, resulting in scabs, sores that never heal, holes in the skin, and scarring

  • Nail and/or cuticle biting, causing bleeding or infected fingertips

  • Blemish picking or squeezing, causing scarring and infections

  • Biting the inside of the cheek


What Causes TTM?

It is not known for certain yet what causes TTM. It is believed that it could be a combination of genetic, emotional, hormonal and environmental factors. For people who have TTM, sometimes a stressful event will trigger the behavior; but sometimes there will be no obvious trigger at all.

When Should Someone Seek Help?

For some people, at some times, trichotillomania is mild and can be remedied by a bit of extra awareness and concentration. In some cases, however, the effects can be severe. It is important for sufferers to find help when it becomes evident that the behavior is out of control.

Signs when a TTM sufferer should seek treatment:

  • Several attempts at stopping have been made but have not worked.

  • The behavior causes feelings of shame which leads to curtailing work, social and educational pursuits.

  • Fear of exposure leads the sufferer to avoid vital medical care of all kinds, from gynecology to dentistry to dermatology.

  • The behavior is effecting the sufferer’s relationships

  • Fights or disputes occur in the family due to the behavior

  • The behavior is limiting the sufferer’s life

Treatment for TTM involves:

  • Awareness training

  • Competing response training

  • Securing social support

  • Mindfulness

  • Interpersonal effectiveness

  • Emotional regulation

  • Distress tolerance

  • Cognitive-behavioral therapy

  • Education for the family to support the individual being treated

  • Linkage with outside resources, website, support groups, books, etc

Talk to a trained professional if you think you or someone you know is struggling with Trichotillomania. Avenues of Counseling and Mediation, LLC has Clinicians specially trained to work with minors and adults dealing with Trichotillomania.

Nicki Masters