Trichotillomania

Trichotillomania is also known as “Hair Pulling Disorder.” Trichotillomania is considered to be an Obsessive Compulsive Disorder (OCD) Spectrum Disorder and one of a group of behaviors known as Body Focused Repetitive Behaviors (BFRBs). Trichotillomania is the repetitive pulling out of one’s own hair or other aberrant self-grooming behaviors in which individuals pull, pick, scrape, or bite their own hair, skin, or nails, resulting in damage to their own body. Common areas of focus are the scalp, eyebrows, eyelashes, nose, legs, arms, hands, and pubic region, and is usually confined to one or two sites. The DSM-5 diagnostic criteria include:

• Recurrent hair pulling resulting in hair loss.
• Repeated attempts to decrease or stop the behavior.
• Clinically significant distress or impairment in social, occupational, or other area of functioning.
• Not due to substance abuse or a medical condition (e.g., dermatological condition).
• Not better accounted for by another psychiatric disorder.

No singular cause of trichotillomania has been identified, but it is thought to be the result of both genetic and environmental factors. Symptoms of trichotillomania usually manifest around the age of 12 or 13, but can begin much earlier or later. Often, stressful events can trigger these symptoms, such as moving, changing schools, abuse, death of a loved one, or familial conflict.

PCH Treatment Center has experienced therapists with expertise in treating trichotillomania using cognitive therapies, group therapies, and individual coaching. Behavioral therapy has shown promising results in increasing awareness of hair pulling behavior, having structured methods of monitoring symptoms, substituting negative behaviors with positive behaviors, and reversing the habit of hair pulling. Medication can also be used to alleviate other symptoms that contribute to trichotillomania, such as anxiety, depression, or obsessive/compulsive thinking. Medication should be used in addition to therapy, as symptoms often return when the medication is stopped without therapeutic intervention.