Information about trichotillomania for Health Professionals
Trichotillomania was once classed as an obsessive compulsive disorder, but it failed to respond to SSRis in the same way as OCD; It was then categorised along with dermatillomania (compulsive skin picking)as an impulse control disorder. Both are now classified as body focused repetitive behaviours, obsessive grooming behaviours including self biting, lip picking and finger chewing.
Trichotillomania compels people to pull out their hair: This can include scalp hair, eyelashes, eyebrows, body hair or any combination of those. Hair pulling can also occur during sleep; this is called Sleep-Isolated Trichotillomania. The average age of onset is 12 years and symptoms can vary in severity.
Dermatillomania generally begins at a slightly younger age although both can begin in babyhood.
BFRB triggers include stress and anxiety, boredom, tiredness, hunger or eating certain foods (commonly sugar and caffeine). Hair pulling differs from self-harm because hair pulling mostly doesn’t hurt; in fact it usually feels pleasurable. Pulling the hair feels good due to a release of dopamine in the brain. You can read more about why people pull their hair out.
51% of 11,625 people we asked had never mentioned hair pulling to their doctor because they were too embarrassed, didn’t think their doctor would help or didn’t know it was a recognised condition. There ARE ways to treat trichotillomania, so we are extremely keen to raise awareness.