Trichotillomania (hair-pulling disorder)

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Treatments and drugs

By Mayo Clinic staff

Research on treatment of trichotillomania is limited. Current approaches focus on:

  • Psychotherapy. A form of psychotherapy called habit reversal training may be an effective treatment for trichotillomania. This type of therapy helps you learn how to recognize situations where you're likely to pull and how to substitute other behaviors instead, such as clenching your fists for a period to "freeze" the urge, or redirecting your hand from your hair to your ear. Sometimes elements of other therapies may be blended with habit reversal training. For instance, your care provider may use cognitive therapy to help you challenge and examine distorted beliefs you may have in relation to hair pulling. Another treatment, acceptance and commitment therapy (ACT), helps people learn to accept their hair-pulling urges while at the same time teaching them how to avoid acting on their impulses.
  • Medications. Your doctor may also recommend that you take an antidepressant, such as clomipramine (Anafranil).
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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