Trichotillomania (Hair-Pulling Disorder)

Trichotillomania (Hair-Pulling Disorder) is a type of Body-Focused Repetitive Behavior (BFRB) characterized by a repetitive or compulsive pulling out of one’s hair, which can lead to damage or hair loss on one’s scalp or other areas of the body, such as eyelashes, eyebrows, chest hair, facial hairs, arm/leg hairs, underarm, or pubic hair. Studies have indicated that 1 or 2 in 50 people experience hair-pulling disorder in their lifetime, and it usually begins around age 12 at the same rate in both boys and girls. However, by adulthood, research indicates that the greater majority of cases are in women.

Symptoms and signs of Trichotillomania:

  1. Behavior can be both intentional/conscious or automatic/subconscious.
  2. Pulling can provide a sense of relief or satisfaction.
  3. Attempt to hide or camouflage hair loss or bald spot.
  4. Behavior can be triggered by boredom, anxiety, stress, perfectionism, and frustration.
  5. Feelings of shame and embarrassment.
  6. May avoid circumstances where puller might be questioned or caught.
  7. Hair pulling can lead to low self-esteem, social anxiety, and depression.

According to research, 5 to 10 million people in the US meet the criteria for Hair Pulling Disorder, with women being four times more likely.



Trichotillomania is more than just a bad habit; it’s a mental health disorder. Therefore, treatment isn’t a simple fix. You must work closely with a professional to help build awareness, understand the root cause, and incorporate alternate behaviors that are less damaging to one’s body. The gold standard treatment for Trichotillomania is CBT (Cognitive Behavioral Therapy), specifically Habit Reversal Training and ACT (Acceptance-Commitment Therapy). Habit Reversal Training involves developing alternative behaviors to replace hair pulling or implementing competing responses, such as clenching fists, playing with a fidget toy, or covering one’s hand with gloves. ACT is also incorporated into treatment to increase psychological flexibility and commit to value-based actions while accepting uncomfortable emotions and urges.
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