What is Trichotillomania?

What is Trichotillomania?


Trichotillomania is a disorder that affects approximately 2-4% of the American population. People who are affected by this condition repeatedly pull out their hair, pick at their skin, or participate in other repetitive behaviors involving damaging the skin or hair. Often, this compulsion becomes unmanageable and requires medical treatment. It can interfere with a person's relationships, affect their work life, and create a negative body image for the affected individual.


Symptoms of Trichotillomania


Typically, people think of Trichotillomania as simply compulsive hair pulling. However, the signs and symptoms of Trichotillomania can be much more involved than that. People with Trichotillomania can pull hair or pick skin from anywhere on the body. Some people choose one localized area to pull from, while others do not discriminate when it comes to what part of the body they utilize. Some even pull the hair of their pets or from other sources like blankets or dolls.

Other symptoms of the disorder include:

  • Biting at the skin or nails
  • Eating hair or skin
  • Playing with the hair or skin that has been removed
  • Hoarding or storing hair or skin that has been removed

Many people participate in Trichotillomania behaviors in private and attempt to hide their behaviors from others.

Types of Trichotillomania

There are two types of Trichotillomania compulsions: focused and automatic.


Focused Trichotillomania: People with the condition will intentionally pull or pick to find relief from the urge they have to participate in the behavior. Some people will even create elaborate rituals or routines for when, where and how they perform the behaviors.


Automatic Trichotillomania: Compulsions happen when the affected person does not even realize it. It can often happen out of boredom or stress. Absentmindedly biting the skin of your lips is one example of an automatic Trichotillomania compulsion.




Causes of Trichotillomania


Concrete medical causes of Trichotillomania are unknown, but it is widely believed by members of the medical community that the disorder may be related to brain pathway abnormalities. These abnormalities can create tension in the body that many people release by compulsively pulling their hair, or picking at or pulling on their skin.


People with anxiety and depression tend to have a higher risk of developing Trichotillomania. Considered an impulse control disorder, Trichotillomania often starts before the age of 17 and women are four times as likely to develop the condition as men.


Before diagnosing a person with Trichotillomania, doctors will often check to make sure that no underlying medical conditions are causing hair loss or skin damage that is contributing to the desire to rid your body of the hair or skin.



Treatment of Trichotillomania


Treatment of Trichotillomania depends on the severity of the disorder and varies from person to person. There is no specific test for the condition, so it is diagnosed only when symptoms present themselves as unmanageable.


There is no cure for Trichotillomania, but symptoms can often be managed with behavioral therapy. This type of therapy teaches patients coping skills and ways to re-direct their hair pulling urges to relieve tension in healthy ways. Some doctors will also recommend taking an antidepressant in order to balance brain chemicals to improve mood and help cope with the negative emotions associated with Trichotillomania.


Trichotillomania is a chronic, long-term condition and the severity of symptoms can vary during different periods of time throughout a person's life. For example, hormonal changes and stressful situations like a job loss or divorce can cause major flare-ups of symptoms, even when undergoing treatment.



Side Effects of Trichotillomania


Unfortunately, Trichotillomania does come with a myriad of side effects.


Social Interaction: If the compulsions are done as a focused activity, meaning the affected person has specific rituals or behaviors that they feel must be done at a certain time. Social interactions can become strained as a result of hiding the behaviors.


Skin Damage: The skin where it has been picked or where hair has been pulled out can become inflamed or even infected depending on the severity of the compulsions. The areas of skin can be tender or red and in need of soothing in the form of lotions or creams. Sometimes, intervention by a dermatologist is needed to help repair the damage done.


Medical Problems: One extreme side effect of Trichotillomania involves the formation of a trichobezoar, which is basically a large hairball inside of the body formed by hair that has be ingested. These masses can lodge themselves in the stomach or intestinal tract and cause internal damage, weight loss or vomiting.


Emotional Stress: The emotional effects of Trichotillomania can deeply affect people with the disorder. Some people feel such shame and embarrassment over their disorder that they avoid social interaction, leading to depression. People with Trichotillomania can feel low self esteem and develop a negative body image due to hair loss or skin damage.



Coping with Trichotillomania


Often, behavioral therapy or attending support groups can help people with Trichotillomania to cope with the emotional stress of the disorder. Voicing concerns, worries or fears to others in a safe setting can be a therapeutic way to relieve the emotional tension caused by Trichotillomania.Turning to family and friends who can offer a listening ear is also a great way to express your emotions and help relieve some of the stress of the disorder.



Cosmetic Solutions


We offer a large selection of products to help people with Trichotillomania feel better about their body image including eyelashes for trichotillomania, hats, wigs and false eyebrows.


The majority of Trichotillomania sufferers will have patches of hair loss somewhere on their body. When the hair loss is primarily located on the head, hats, scarves and wigs are often needed to conceal the hair loss.


Wearing a headcover can help people affected by Trichotillomania gain confidence by allowing them to appear in social situations without their hair loss showing. Scarves and hats that are soft like the items found in our Luxury Bamboo Headwear are often desired due to the scalp sensitivity that occurs when the hair is pulled out.


Some people with sparse areas of hair loss on the head may not even need a full wig. We offer many hairpiece options including hair toppers with different amounts of coverage depending on your needs. Our certified wig specialist can also help determine what type of hairpiece or wig you need when you set up a free wig consultation.


Eyelashes and eyebrows are two common areas that people also pull hair from. Our realistic eyebrows and eyebrow tattoos are great solutions for people who have pulled hair out of the eyebrow area. We offer a selection of false eyelashes including options that are perfect for both Trichotillomania sufferers who have lost all of their lashes as well as those with lashes that are thinning and sparse because of the pulling.


We also offer several great skincare products that help soothe the skin in areas where hair has been pulled or skin has been picked. We even have lip care items like our Aloe Lip Care Lip Treatment stick that can help to protect and heal the lips of Trichotillomania sufferers who bite or pick at their lips.





The symptoms and side effects of Trichotillomania can affect a person's entire life. With help from doctors, therapists and the support of friends and family, coping with the effects of Trichotillomania is very possible. Take advantage of using every tool available to you - including our headwear, wigs and skincare items - to help you feel your best when dealing with Trichotillomania.

Additional Resources


Comments, Questions & Ratings

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Beverlyc576@gmail.com Review by What is Trichotillomania?
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It is very uncommon and I have both I've had it since I was about 12 or 11 I started chewing and pulling hair and picking and it only gets more and more it gets aggressive and eventually it gets repulsive but I can't say that all ever stop I'm 51 and it has not stopped (Posted on 12/13/2018)

Trichotillomania help Review by What is Trichotillomania?
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I suffer from trichotillomania and have been since I was 16. I'm now 27. I stopped on my own for five years but had a terrible relapse and last week I had about an eight hr pulling session which has sadly left me with a huge bald spot on the top of my head. I was wondering what types of products you have to offer for someone with my condition. Thanks so much! Shirley. (Posted on 05/31/2017)


Hi Shirley. First, congratulations on making it five years. That is a huge accomplishment so don't be too hard on yourself for this. We would recommend looking at our hair toppers. Depending on the size of the bald spot, a topper could blend in with your own hair without the need for a full wig. Hats are also idea for covering those bald spots as well. We have a huge selection of hats and toppers here. Please contact us at 1-800-264-4287 if you need any help finding them or further advice. (06/24/2017)
Trichotillomania and Dermatillomania Review by What is Trichotillomania?
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Skin picking actually has a name of it's own, dermatilomania, while Trich is used specifically in relation to hair pulling. It is not uncommon for them to be found together, however, and they are both classified as body focussed repetitive behaviours. The TLC Foundation for BFRB's is also a great resource to learn more, and they do some awesome work. (Posted on 05/24/2017)

It has a name Review by What is Trichotillomania?
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Thank you for including this article on your site. I've recently learned that I have trichotillomania and I'm still learning. Just knowing it has a name and that others have gone through the same thing is so helpful. (Posted on 02/13/2017)

Good resource on trichotillomania Review by What is Trichotillomania?
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So many articles out there miss important points on this disorder. I appreciate you being so thorough in your coverage. By the way, I love your eyelashes! They are the best! (Posted on 01/07/2017)

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