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Trichotillomania is a condition which is characterized by an irresistible desire to pull out or pluck the hair from the scalp, the eyebrows or from other regions of the body. Such activity that involves hair pulling tends to leave several bald patches on the scalp. Individuals afflicted with trichotillomania often go to great lengths to disguise or hide such bald spots.

Some individuals may have mild or moderate cases of trichotillomania, which can be managed by them. Others are not be so lucky and are constantly tempted to pull out the hair. This often leads to severe distress and restlessness.

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Symptoms of trichotillomania

Some of the signs and symptoms of trichotillomania are listed below:

  • The most common symptom is repeated pulling out of the hair usually from the scalp, the eyelashes and the eyebrows. Hair pulling is not limited to these areas and can extend to other parts of the body as well
  • An overwhelming desire to pull out the hair. Once the hair has been pulled out, there are sensations of relief and comfort
  • The scalp as well as other parts of the body may have patches of bald spots.
  • The eyebrows or the eyelashes may have few hairs or they may be absent.
  • The hair that is pulled out may be chewed or in some cases eaten
  • The pulled out hair may become a toy to play with, or an object of affection
  • Individuals may also rub the hair that has been pulled out across the face or the lips
  • Most individuals affected by the disorder tend to hide it and may engage in hair pulling activity in privacy of their homes or other places
  • Some individuals may engage in hair pulling activity with fervor, extreme focus and intention. Such individuals are aware of the fact that they are pulling out their hair and may even create extensive rituals for conducting such activities. Some other individuals may unconsciously engage in hair pulling activities. Depending on the situation or the mood the same individual may also do both.
  • Instances of hair pulling activity that is intentional include indulgence in pulling out one’s hair when one is frustrated in a traffic jam. Unconscious hair pulling activity often tends to occur when one is bored.
  • Certain body positions such as resting the head on the hand or other rituals such as hair brushing may also trigger hair pulling activities.

Some of the complications of trichotillomania include:

  • Increased instances of psychological disorders and emotional distress: Many affected individuals report feeling humiliated, ashamed and embarrassed as a result of the disorder. Additionally they may experience depression, anxiety and low self-esteem.
  • Social isolation and other problems: Individuals with trichotillomania end up avoiding swimming, windy conditions as well as haircuts to prevent potential embarrassment. They may disguise or hide their bald patches with elaborate wigs or false eyelashes. Fear of their condition being discovered also leads such individuals to avoid relationships or intimacy.
  • Damage to the skin: Hair pulling that is constant and persistent can lead to the development of abrasions and other damage such as infections to the scalp-skin or the skin of the other body parts where the hair is being pulled out from
  • Formation of hairballs: The intake of pulled-out hair can lead to the development of big, matted hairballs in the digestive tract of individuals afflicted with trichotillomania. Such hairballs can lead to vomiting, loss in weight, intestinal obstruction and even fatality over the course of a few years.

Causes of trichotillomania

  • There are no known causes of trichotillomania. However, research studies have indicated at a combination of genetic and environmental factors as being the cause. Additionally, abnormalities of the brain chemicals such as dopamine and serotonin may also lead to the development of trichotillomania.

Some of the risk factors of trichotillomania include the following:

  • A family history of the disorder increases the chances of getting the disorder
  • Adolescents in the age group of 11 and 13 are more vulnerable to the disorder
  • Individuals, who not have access to different methods to alleviate negative emotions such as tension, stress, lowliness, anxiety, etc., are at increased risk to develop trichotillomania. Hair pulling activities tend to act as positive reinforces in such people due to the resultant feelings of calm and relief.
  • Presence of other disorders such as OCD, depression or eating disorders may also increase the risk of trichotillomania

Treatment of trichotillomania

Trichotillomania can be treated in the following ways:

  • A form of psychotherapy that teaches the affected individuals to recognize the situations and moods that may trigger a hair pulling instance and to substitute other physical actions like clenching the fist during such situations. Some other forms of psychotherapy, such as cognitive therapy are used to challenge the beliefs of the patients and offer other coping methods.
  • Antidepressant medications such as clomipramine may be prescribed by a physician.
  • Alternative therapies for trichotillomania treatment include hypnosis as well as muscle and breathing relaxation techniques
  • Joining a support group for trichotillomania may help alleviate the loneliness that is associated with trichotillomania.
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