Trichotillomania

Trichotillomania is a compulsive hair-pulling disorder that is often thought to be anxiety-related.

People with this disorder have the irresistible and recurring urge to pull hair from parts of their body, such as from the scalp or eyelashes. Trichotillomania can be manageable for some people who have gained psychological support and treatment which has helped reduce and even completely stop these hair pulling impulses.

Signs & symptoms may include: 

• Feeling an intense urge to pull own hair out
• Feeling a growing sense of discomfort and anxiety until starting to pull hair
• Feeling a sense of relief gained directly from pulling out hair- self-soothing 
• Pulling out hair in response to a stressful situation/ done without noticing 
• Feeling shame, guilt and low self-esteem surrounding this disorder 
• Bald patches left on the head tend to have an unusual shape and may affect one side more than the other.

Most people with trichotillomania pull out hair from parts of their own body such as their:

• Hair on scalp
• Eyebrows
• eyelashes
• genital area
• beard or moustache

Causes of hair pulling tend to be related to ways of dealing with stress and anxiety which can be associated from boredom, loneliness, fatigue or frustration. There is evidence to suggest that for some it may be induced by a chemical imbalance in the brain like in Obsessive-Compulsive Disorder. A change in the hormone level, especially during puberty can also increase the risk of developing the disorder. It is also understood that some people may use it to self-harm as a way of coping with emotional distress. This type of anxiety disorder can become chronic - meaning long term and difficult to gain control over. This is especially so if ignored and left without treatment, symptoms can worsen and even go on for years. 

It is important to seek help as early as possible if you notice that you have any symptoms of the disorder, even if they are not too severe. The earlier the treatment intervention and support the greater chances of preventing the disorder from worsening. It is important to understand that trichotillomania is not simply a bad habit but a mental health condition which can become harder to deal with if not treated at an earlier point. 

Treatment and self-care: 

A lot of people may feel anxious and embarrassed about having trichotillomania and seeking help and treatment can be difficult, especially during a time of uncertainty.

Key steps to seeking help:

•  First see if you can relate to any of the symptoms previously listed 
• Contact your local general practitioner/ health specialist and book an appointment to get specialist guidance for beginning treatment.
• Communicate how you are feeling to others you feel comfortable with 

Side note: It may be useful to communicate your concerns of potentially having trichotillomania to someone else. Telling a trusted family member/friend about how you are feeling and planning on seeking help and treatment can improve social support and understanding from others, as well as reinforce your planned behaviour to be proactive in seeking immediate treatment and taking care of yourself. It may be more comforting for you to visit or phone call your health care centre with the knowledge that another person is aware and supportive of you seeking help. It may be more reassuring to attend the doctor’s appointment with someone else you know. 

A common psychological treatment of Cognitive behavioural therapy (CBT) may be directed to people with trichotillomania. CBT is used as a method of reversed habit training, which involves replacing self-harming habits like hair pulling with healthier coping mechanisms, such as:

• Journaling- Having a diary of your hair pulling and own personal thoughts
• Uncovering the triggers- Identifying and discussing the stressors of hair pulling and learning how to avoid them
• Replacing hair pulling with another action, like stoking a fluffy cushion or squeezing a stress ball
• Engaging with loved ones- helps to provide emotional support 

Self- care guidance

Here are some simple ways to help manage hair pulling when this urging feeling arises:

• Squeeze a stress ball/ use a fidget toy 
• Stroke a soft pillow/ fluffy item 
• Self-massaging/ getting someone else to give you a massage 
• Make a ball with your fist, tighten the muscles in that arm and then relax (attempt this 2-5 times or more if need be)
• Wear a bandana or a tight-fitting hat
• Have a bath to help ease any stress or anxiety
• Practise deep breathing until the urge passes 
• Trying guided meditation and mindfulness 
• Pick up a new and fun hobby to help re-direct your attention- e.g. gardening, yoga, painting, 
• Frequent exercise and getting outdoors 
• Wear gloves