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Risk factors
By Mayo Clinic staffThese factors may increase your risk of trichotillomania:
- Family history. Trichotillomania tends to run in families. If someone in your family engages in hair pulling, you're more likely to do it too.
- Age. Trichotillomania usually develops in adolescence — most often around age 12 — and is often a lifelong problem. It may be triggered initially by a stressful event, such as moving, changing schools or the death of a parent. It may also be triggered by hormonal changes that occur during the teen years. Children younger than age 5 can also be prone to hair pulling, but this is usually mild and goes away on its own without treatment. Young children tend to pull their hair at bedtime or nap time, whereas older children with trichotillomania pull their hair to relieve stress.
- Your sex. Although far more women than men are treated for trichotillomania, this may be because women are more likely to seek medical advice. In early childhood, boys and girls appear to be equally affected.
- Hair characteristics. Some people who pull out their hair say that they do so because they're bothered by hair that's a particular texture or color.
- Negative emotions. For many people with trichotillomania, hair pulling is a way of dealing with negative or uncomfortable feelings, such as stress, anxiety, tension, loneliness, fatigue or frustration. People who have trichotillomania may also have other emotional disorders, including depression, obsessive-compulsive disorder or eating disorders.
- Positive reinforcement. Some people find that rubbing pulled hair against their faces or lips feels good, or that pulling out hair feels satisfying. As a result, they continue to pull their hair to maintain these positive feelings.
References
- Woods DW, et al. Trichotillomania: An ACT-enhanced Behavior Therapy Approach Therapist Guide. New York, N.Y.: Oxford University Press; 2008.
- Fact sheet: Trichotillomania. Mental Health America. http://www.nmha.org/index.cfm?objectid=C7DF9926-1372-4D20-C88C1DDD5A71D709. Accessed Dec. 1, 2008.
- About trichotillomania. Trichotillomania Learning Center. http://www.trich.org/about_trich. Accessed Dec. 1, 2008.
- Trichotillomania in childhood: Case series and review. Pediatrics. 2004;113:3494.
- Trichotillomania. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Dec. 1, 2008.
- Alternative treatments. Trichotillomania Learning Center. http://www.trich.org/treatment_resources/Alternative.asp. Accessed Dec. 1, 2008.
- Chamberlain SR, et al. Lifting the veil on trichotillomania. American Journal of Psychiatry. 2007;164:568.
- Walsh KH, et al. Trichotillomania. Presentation, etiology, diagnosis and therapy. American Journal of Clinical Dermatology. 2001;2:327.
- Zuchner S et al. SLITRK1 mutations in Tricholtillomania. Molecular Psychiatry. 2006;11:888. http://www.nature.com/mp/journal/v11/n10/full/4001865a.html. Accessed Dec. 29, 2008.
- Woods DW et al. Understanding and Treating Trichotillomania: What We Know and What We Don't Know. Psychiatric Clinics of North America. 2006;29:487. http://www.mdconsult.com/das/article/body/114970872-3/jorg=journal&source=MI&sp=16170821&sid=786898514/N/532552/1.html?issn=0193-953X. Accessed Dec. 29, 2008.
