Trichotillomania (hair-pulling disorder)

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Symptoms

By Mayo Clinic staff

Signs and symptoms of trichotillomania often include:

  • Repeatedly pulling your hair out, typically from your scalp, eyebrows or eyelashes, but it can be from other body areas as well
  • A strong urge to pull hair, followed by feelings of relief after the hair is pulled
  • Patchy bald areas on the scalp or other areas of your body
  • Sparse or missing eyelashes or eyebrows
  • Chewing or eating pulled-out hair
  • Playing with pulled-out hair
  • Rubbing pulled-out hair across your lips or face

Most people with trichotillomania pull hair in private and generally try to hide the disorder from others.

For some people, hair pulling is intentional and focused. They're aware that they're pulling their hair out and may even develop elaborate rituals for doing so. Other people pull their hair unconsciously. The same person may also do both, depending on the situation and mood. For example, focused hair pulling may occur when you're frustrated in the car. Or you may unconsciously pull hair when you're bored. Certain positions or rituals may trigger hair pulling, such as resting your head on your hand or brushing your hair.

References
  1. Duke DC, et al. Trichotillomania: A current review. Clinical Psychology Review. 2010;30:181.
  2. 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.
  3. Stein DJ, et al. Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: Toward DSM-V. Depression and Anxiety. 2010;27:611.
  4. Chamberlain SR, et al. Trichotillomania: Neurobiology and treatment. Neuroscience and Biobehavioral Reviews. 2009;33:831.
  5. Chamberlain SR, et al. Lifting the veil on trichotillomania. American Journal of Psychiatry. 2007;164:568.
  6. Tay YK, et al. Trichotillomania in childhood: Case series and review. Pediatrics. 2004;113:e494.
  7. 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.
  8. Shenefelt PD. Biofeedback, cognitive-behavioral methods, and hypnosis in dermatology: Is it all in your mind? Dermatologic Therapy. 2003;16:114.
DS00895 Jan. 19, 2011

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