Desmond Kaplan MD FAPA

Child, Adolescent & Adult Psychiatry

1777 Reisterstown Road, Suite 50
 Baltimore, MD 21208


Trichotillomania, also known as hair-pulling disorder, is a mental illness in which people have uncontrollable urges to pull out the hair on their scalp, eyebrows or other areas of the body. This action often results in patchy bald spots on the head and causes feelings of guilt, shame and severe emotional pain, especially when those afflicted are trying to hide their condition. People with trichotillomania most often pull hair from their scalp and may do so using their fingers, tweezers or brushes. They may enjoy playing with pulled out hair or rubbing it across the face. The hair pulling may result in patchy bald areas or missing eyelashes and eyebrows. Women are more likely than men to have trichotillomania and it usually develops during adolescence.

Causes of Trichotillomania

Trichotillomania is classified as an impulse control disorder and the exact cause is unknown. Although the action may be harmful to themselves or others, individuals with trichotillomania cannot resist the urge to do it. Like many complex disorders, trichotillomania may be the result of a combination of genetic and environmental factors. Abnormalities in the release of natural brain chemicals, which include serotonin and dopamine, may also play a role in the development of trichotillomania. Individuals with trichotillomania may also suffer from depression, anxiety and low self-esteem.

Symptoms of Trichotillomania

The main symptom of trichotillomania is the uncontrollable urge to pull hair from the scalp, eyebrows and eyelashes, yet any other areas of the body with hair can be affected. Most people with trichotillomania engage in the act of hair pulling in private and try to hide this disorder from others. Additional symptoms of trichotillomania may include:

  • Bald spots or patches of missing hair
  • Thin or missing eyebrows or eyelashes
  • Constant tugging, pulling or twisting of hair
  • Engaging in other self-injury behaviors

Treatment of Trichotillomania

The main form of treatment for trichotillomania is psychotherapy. Cognitive behavioral therapy may be used in combination with habit reversal training to help control the urges pull out hair. Cognitive behavioral therapy helps the individual to identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones. Medication in the form of antidepressants may be also be used to treat trichotillomania. Support groups can also be beneficial to individuals who are trying to stop the behaviors associated with trichotillomania.

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