The Urge to Pull: Trichotillomania

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Most people agree that having hair pulled out is a very unpleasant feeling. For someone with trichotillomania, though, pulling hair out feels good — and may help the person deal with stress and anxiety. Trichotillomania is one of the more unusual hair loss diseases. What causes this hair loss disorder, and can it be cured?

What Is Trichotillomania?

Trichotillomania (TTM) is a disorder that causes a person to have an overwhelming urge to pull out their own hair. Symptoms of trichotillomania include:

  • noticeable hair loss
  • increased tension right before pulling out hair, or when trying to resist pulling
  • pleasure or relief when hair is pulled

As long as hair pulling is not caused by another health issue, and it causes the puller enough problems to interfere with daily life, it can be classified as trichotillomania.

TTM is closely related to obsessive-compulsive disorder. The International OCD Foundation sheds light on the difference between the two:

  • OCD sufferers have repetitive behaviors that distract from bad feelings but do not bring pleasure.
  • TTM sufferers get pleasure or relief from pulling hair.

Scientists do not know the cause of TTM. Symptoms of TTM increase when the body encounters stress. Interestingly, this stress can be either negative stress (e.g., money problems) or positive stress (e.g., planning a trip). The brain does not differentiate between the signals, so both types of stress can increase the desire to pull hair.

What Are Complications of TTM?

On an emotional level, the sufferer may experience tremendous stress and shame because of their behavior. This can prevent them from going to work, engaging in social activities or pursuing higher education. Physically speaking, one of the worst complications occurs when a person eats the hair they pull. Strands of hair can build up in the intestines and cause painful, even life-threatening blockages, which may require surgery.

Can Trichotillomania be Cured?

There are several treatments for TTM. Different methods may work for some and not for others.

Cognitive Behavior Therapy

Cognitive Behavior Therapy (CBT) interrupts and resets the mental processes that lead to hair pulling. Through CBT, the patient identifies the factors that lead to the desire to pull, then learns techniques that can redirect those urges. To be effective, CBT should be performed by a qualified psychologist.

Medication

There are several medications that have been helpful for TTM patients. Among the most effective are the antidepressant clomipramine and the amino acid N-acetyl cysteine. SSRIs like Prozac have had mixed results; a few patients have reported that they stopped pulling their hair completely, while others felt no effect whatsoever.

Support Groups

Because sufferers of trichotillomania deal with debilitating of shame, support groups can be very helpful. Hair pullers may find that being in a support group helps them to focus their energies on finding an effective strategy, rather than hiding their disorder and feeling embarrassed.

Alternative Therapies

Certain hair pullers have reported success with alternative therapies like biofeedback, hypnotism or a strict regimen of diet and exercise. These methods have not been studied by scientists, so their usefulness remains in question.
Who Suffers from Trichotillomania?

Trichotillomania often begins in childhood or adolescence, but TTM symptoms can onset at any time in life. Boys and girls seem to be equally affected in childhood, but among adults, TTM appears to be more common among women.

Actress Olivia Munn has been open about suffering from Trichotillomania. In an interview for Self magazine, she speaks of the stress that brought on hair pulling. “I had it growing up, having had a little bit of a tumultuous upbringing, moving around a lot with a mixed family with five kids.” She remarked that the stress of being an actress has, at times, brought that anxiety back. “I just didn’t want to let anybody down,” she said.

Trichotillomania can affect anyone at any age. VanScoy Hair Clinics specializes in hair replacement and hair loss solutions for those who suffer from Trichotillomania. We have many options to choose from. To learn more, call us at (419) 289-6665 or click here and make an appointment online.

Photo Credit: Martin Cathrae Via Flickr Creative Commons

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