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Risk factors
By Mayo Clinic staffThese factors tend to be associated with trichotillomania:
- Family history. Susceptibility to trichotillomania may be inherited.
- Age. Trichotillomania usually develops during adolescence — most often between the ages of 11 and 13 — and is often a lifelong problem. Children younger than age 5 also can be prone to hair pulling, but this is usually mild and goes away on its own without treatment.
- 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.
- 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.
- Positive reinforcement. People with trichotillomania often find that pulling out hair feels satisfying and provides a measure of relief. As a result, they continue to pull their hair to maintain these positive feelings.
- Other disorders. People who have trichotillomania may also have other disorders, including depression, anxiety, obsessive-compulsive disorder or eating disorders. Nail biting and skin picking have also been associated with trichotillomania.
References
- Duke DC, et al. Trichotillomania: A current review. Clinical Psychology Review. 2010;30:181.
- 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 Oct. 12, 2010.
- Stein DJ, et al. Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: Toward DSM-V. Depression and Anxiety. 2010;27:611.
- Chamberlain SR, et al. Trichotillomania: Neurobiology and treatment. Neuroscience and Biobehavioral Reviews. 2009;33:831.
- Chamberlain SR, et al. Lifting the veil on trichotillomania. American Journal of Psychiatry. 2007;164:568.
- Tay YK, et al. Trichotillomania in childhood: Case series and review. Pediatrics. 2004;113:e494.
- Moritz S, et al. Movement decoupling: A self-help intervention for the treatment of trichotillomania. Journal of Behavior Therapy and Experimental Psychiatry. In press. Accessed Oct. 12, 2010.
- Shenefelt PD. Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: Is it all in your mind? Dermatologic Therapy. 2003;16:114.
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