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Trichotillomania Hair-Pulling Disorder: Causes, Symptoms and Treatment

Author: Thomas C. Weiss : Contact: Disabled World

Published: 2015-07-28 : (Rev. 2019-05-03)

Synopsis:

Information regarding Trichotillomania, a disorder in which a person has irresistible and recurrent urges to pull out their own body and scalp hair.

Key Points:

Main Digest

Trichotillomania is a disorder involving irresistible and recurrent urges to pull out eyebrows, hair from the person's scalp, or other areas of the affected person's body, despite attempts to stop. Hair-pulling from the scalp often times leaves patchy bald spots which causes significant distress and may interfere with work or social functioning. People with the disorder might go to great lengths to disguise their loss of hair. For some people, trichotillomania might be mild and generally manageable. For others affected by this disorder, the compulsive urge to pull hair is overwhelming. Some treatment options have assisted people with reducing their hair pulling, or to stop.

Symptoms of Trichotillomania

A number of symptoms of trichotillomania exist. Among these symptoms are the ones listed below.

The majority of those with trichotillomania also pick their skin, chew their lips, or bite their nails. At times, pulling hairs from pets or dolls, or materials such as blankets or clothes, might be a sign. Most people with trichotillomania pull their hair in private and usually attempt to hide the disorder from other people. For people with trichotillomania, hair-pulling may be:

Automatic: Some people pull their hair without realizing they are doing so. They may pull their hair when they are bored, watching television, or reading.

Focused: Some people pull their hair intentionally in order to relieve distress or tension. For example; the affected person may pull their hair out to gain relief from the overwhelming urge to pull their hair. Others might develop elaborate rituals for hair-pulling, such as finding a particular hair, or biting hairs they have pulled.

A person with trichotillomania might do both automatic and focused hair-pulling depending upon their mood or the situation. Certain positions or rituals may trigger hair-pulling such as resting your head on your hand, or brushing your hair. Trichotillomania is a long-term disorder; without appropriate treatment, symptoms can vary in severity over time. For example; the hormonal changes of menstruation may worsen symptoms in women with the disorder. For some people, if treatment is not received, the symptoms can come and go for weeks, months or even years at a time. On rare occasion, hair-pulling ends within a few years of beginning.

Causes of Trichotillomania

The cause of trichotillomania is unclear at this time. Yet like a number of complex disorders, trichotillomania most likely results from a combination of environmental and genetic factors. Abnormalities in the natural brain chemicals, 'serotonin,' and, 'dopamine,' might play a part in the disorder.

Risk factors for Trichotillomania

Some different factors tend to increase a person's risk of trichotillomania. These risk factors include the following:

While many more women than men are treated for trichotillomania, it might be because women are more likely to pursue medical attention. In early childhood, girls and boys seem to be equally affected.

Complications

Although it might not appear particularly serious, trichotillomania can have an immense impact on a person's life. Complications of the disorder can include the following:

Tests and Diagnosis

A doctor will perform a complete evaluation to determine if you have trichotillomania. The evaluation may include the following:

To achieve a diagnosis of trichotillomania, you have to meet criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The manual is used by mental health professionals to diagnose mental conditions, as well as by insurance companies to reimburse for treatment. The DSM criteria for a diagnosis of trichotillomania include the following:

Trichotillomania Treatments

At this time, research on treatment of trichotillomania is limited. Some treatment options; however, have helped people to reduce their hair-pulling, or stop it. What follows are descriptions of treatment options for this disorder.

Medications and Trichotillomania

There are no medications that are approved by the Food and Drug Administration (FDA) specifically for treatment of trichotillomania.

Some medications; however, might help to control your symptoms. For example; a doctor might recommend an antidepressant such as clomipramine.

Other medications that research suggests may have some benefit include N-acetylcysteine - an amino acid that influences neurotransmitters related to mood, or olanzapine which is an atypical antipsychotic.

It is important to discuss with a doctor any medication they might suggest. The potential benefits of medications should always be balanced against possible side-effects.

Facts and Statistics

Trichotillomania, also known as trichotillosis or hair pulling disorder, is defined as an Impulse Control Disorder characterized by the compulsive urge to pull out one's hair, leading to hair loss and balding, distress, and social or functional impairment. Trichotillomania may be present in infants, but the peak age of onset is 9 to 13. It may be triggered by depression or stress.

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