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Treatments and drugs
By Mayo Clinic staffThere's little research about treatment of trichotillomania because it's only been formally recognized as a disorder since the late 1980s. Right now, two main treatments stand out:
- Psychotherapy. Studies have shown that a form of psychotherapy called cognitive behavior therapy (CBT) is an effective treatment for trichotillomania. CBT teaches you to become more aware of pulling, and helps you learn to reverse the habit. You also learn what emotions and triggers are involved in hair pulling and how to substitute other behaviors instead. Sometimes elements of other therapies may be blended with CBT. For instance, 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. Doctors sometimes use antidepressants to treat trichotillomania. But these drugs can have troublesome side effects, and some people can't tolerate them. Medications work best when combined with cognitive behavior therapy, not when used as the sole treatment.
Relapses are common, even when treatment is successful initially.
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.
