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Genetic and Rare Diseases Information Center (GARD)

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Other Names for this Disease
  • Hair-pulling syndrome
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What is trichotillomania?

How might trichotillomania be treated?

What is trichotillomania?

Trichotillomania is an impulse control disorder characterized by an overwhelming urge to repeatedly pull out one's own hair (usually on the scalp), resulting in hair loss (alopecia). The eyelashes, eyebrows, and beard can also be affected. Many affected individuals feel extreme tension when they feel an impulse, followed by relief, gratification or pleasure afterwards. The condition may be mild and manageable, or severe and debilitating. Some individuals chew or swallow the hair they pull out (trichophagy), which can result in gastrointestinal problems. The exact cause of the condition is unknown. Treatment typically involves psychotherapy (including cognitive behavior therapy) and/or drug therapy, but these are not always effective.[1]
Last updated: 11/30/2012

How might trichotillomania be treated?

Behavioral treatment seems to be the most powerful treatment for trichotillomania. Parental involvement is important and should include enough support so that affected children grow well intellectually, physically, and socially. Shaving or clipping hair close to the scalp may be helpful to stop the behavior.[2]

Professional cognitive behavior therapy (CBT) is recommended if initial approaches are unsuccessful. CBT typically involves self monitoring (keeping records of the behavior); habit-reversal training; and stimulus control (organizing the environment). CBT is typically effective in highly motivated and compliant patients. The success of therapy may depend on firm understanding of the illness and the cooperation of the family members to help the affected individual comply with treatment. Several courses of CBT may be needed.[2]

No medication has been approved for the treatment of trichotillomania, and medications used have not been consistently effective. Selective serotonin reuptake inhibitors have been utilized but responses to treatment have not been consistent. Fortunately, several recent studies regarding drug therapy for trichotillomania show promise. While drug therapy alone is currently generally not effective, combination therapy and other treatments may be helpful.[2]

More detailed information about current treatment options for trichotillomania is available on Medscape Reference's Web site and can be viewed by clicking here. You may need to register on the Web site, but registration is free.
Last updated: 11/30/2012

  1. Trichotillomania. NORD. January 19, 2011; Accessed 11/28/2012.
  2. Carly A Elston. Trichotillomania. Medscape Reference. August 26, 2011; Accessed 11/30/2012.