Trichotillomania

Everyone occasionally experiences impulses to carry out behavior that they would prefer not to do. However, these impulses are not persistent, nor interfere with day-to-day life.

Trichotillomania is the repeated urge to pull out hair, usually from the head, but sometimes also from the eyelashes, face, nose, genital areas, eyebrows, and other areas of the body. Although the person may initially resist the impulse, this results in an increasing sense of tension and a relief of tension when the hair is pulled. Trichotillomania falls under the category of an impulse control disorder, but has also been associated with Obsessive-compulsive Disorder.

Trichotillomania does not interfere with a person’s ability to work, play, and generally live his or her life. However, the cycle of resisting and yielding to the impulse wears on a person’s self-esteem. The greatest toll on the individual’s self-esteem, however, is the social stigmatization that occurs due to loss of hair. This is especially the case when the person develops bald patches on the head. People with trichotillomania often do whatever they can to conceal the area. At first, they may simply style their hair in a way that covers up the bare patches, but eventually begin to wear a hat, scarf, or wig.

Hair pulling becomes habitual when people begin pulling without being aware of what they are doing. Most people also have a specific routine with regard to hair pulling and are more likely to pull at certain times and in specific situations. This routine may also include rituals with regard to playing with the hair, chewing it, and sometimes eating it. Most people find that their trichotillomania worsens when under stress.

There are a number of other habitual problems, such as nail biting or compulsive skin picking (i.e., dermatotillomania). These problems are treated in a similar manner to trichotillomania.

Treatment:

The treatment for trichotillomania and other habitual problems requires a great deal of commitment on the part of the individual struggling with this problem.  Some people find medications to be helpful, but the most effective treatment is a form of Cognitive Behavior Therapy that includes Habit Reversal Training. In addition, many people benefit from learning cognitive behavioral coping strategies that can be utilized when their trichotillomania or other habitual problem is activated by stress. A combination of medication and therapy may work best for some individuals.

If you or someone you know is suffering from trichotillomania contact one of our psychologists today at either the Calgary (403-313-8309) or Vancouver (1-877-313-8309) office to see how we can be of help. You can also contact us by e-mail.