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Trichotillomania


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Trichotillomania is characterized by a tremendous urge to repeatedly pull out one’s own hair, resulting in repetitive hair pulling and subsequent hair loss. Some affected individuals chew and/or swallow (ingest) the hair they have pulled out (trichophagy), which can lead to digestive issues. Hair pulling disorder was previously classified as an impulse control disorder but is now reclassified as an obsessive-compulsive related disorder. This can occur in conjunction with a variety of conditions including depression, anxiety disorders, obsessive-compulsive disorder (OCD), or attention deficit hyperactivity disorder (ADHD).

Who is affected

Females=males in childhood and Females>Males in adulthood.

Few weeks to many years in duration

0.5-3 percent lifetime prevalence.

Symptoms

  • The primary symptom of trichotillomania is repeated pulling out of one’s own hair, and significant distress and leading to functional impairment.
  • The scalp is the most affected area in trichotillomania. Affected individuals might break off pieces of hair or pull out entire strands.
  • Other areas such as the eyebrows, beard, hands or pubic areas may also be involved.
  • Individuals with trichotillomania may deny and conceal their behavior with the help of wigs, fake eyebrows, and eyelashes.

Anxiety, depression and obsessive-compulsive disorder may be prominent features.

Causes

  • A genetic predisposition.
  • Anxiety and agitation seem to exacerbate episodes of trichotillomania.
  • Childhood trauma.
  • Functional and structural brain changes.

Treatment

Psychotherapy for trichotillomania includes

Cognitive behavior therapy, which attempts to identify and alter the thoughts and feelings that result in certain behaviors such as hair pulling. Types of cognitive tendencies therapy utilized to treat people with trichotillomania consist of habit reversal, stimulus control, and awareness training.

Pharmacotherapy for hair pulling disorder, a number of agents including olanzapine, clomipramine, SSRIs such as fluoxetine have been effective in treating hair pulling disorder. N acetyl cysteine has also been found to be effective, with least propensity to cause side effects.

We offer effective treatment for trichotillomania and other related disorders.