Trichotillosis What You Should Know About Hair Pulling

Hair loss is bad enough. What is even worse is when it is self-inflicted, as in the case of Trichotillosis. For the uninitiated, it can be hard to understand, but it does happen. As a matter of fact, it is estimated that at least 2% of the American population have this disorder. However, precise figures cannot be acquired because most people who suffer from this condition do not want to reveal that they do.

What is Trichotillosis?

Trichotillosis, also known as Trichotillomania, TTM or Trich, is severe hair-pulling. Yes, pulling on one's hair isn't just an idiom; it is a medical condition. The root words are derived from the Greek language – trikh meaning hair, tillo meaning pull and mania meaning madness. Trich can either be a habit, a manifestation of an OC (obsessive compulsive) disorder, an addiction or a tic disorder. It is generally believed to be genetic and that it is triggered by stress or anxiety. The problem is that most information about this condition is preliminary.

Signs and Symptoms

Trichotillomania can either be out of habit or out of want for gratification felt because of hair-pulling. It is actually noticeable, especially for people who do the pulling out of habit. If one is more aware and feels guilty, the hair pulling is usually done discreetly. You would notice that a person with this condition has irregular bald spots in various parts of the scalp, although it is possible for the person to pull hair out of a single spot. The eyebrows, eyelashes and pubic hair are also sometimes pulled out. What you will notice about Trichotillomania is that the patient has the same hair density, as opposed to those suffering from pattern baldness, and that the hair has different lengths, which was due to pulling.

There seems to be a stress component involved. Studies show that in low-stress environments, the patients do not feel much urge to pull hair. The problem with this condition is that while it is self-inflicted, it might result to long-term hair loss due to scalp trauma. In some cases, patients even ingest the hair the pull out (clinical term is Tricophagia).

Diagnosis and Treatment

As mentioned, clinicians have a hard time diagnosing this condition because people tend to hide it, like how one denies biting fingernails at times. It is also said that aside from the stress factor, people also engage in hair pulling because of the gratification that they get out of doing so. However, there are also people who claim that they do it without being aware that they are doing it, ad without being conscious of the feeling of gratification

If patients admits hair-pulling, then diagnosis is speedy. Otherwise, the dermatologist takes a different approach where the appearance of the hair loss patch is examined to eliminate pattern baldness or other hair loss causes such as loose anagen (medical term for hair in the growth stage) syndrome.

Treatment would depend on the age of the patient. It is ignored in pre-school children, as it will most likely be outgrown. For pre-teens to young adults, establishing diagnosis as well as awareness is vital. The patient must not feel guilty and helpless; after all it is a medical condition that can be treated. For adults, the problem is usually has a stress-related and it is important to know about the triggers.

Treatment is either by intake of medication or by behavioral motivation. In cognitive behavior therapy, there is habit reversal and stimulus control involved. The patient needs to be highly aware of the problem and find out about the triggers. When the impulse does occur, it should be diverted by doing a substitute action. Acceptance and commitment therapy is also needed in which you would accept that you want to pull the hair without actually pulling your hair.

Medicines such as clomipramine are prescribed in some cases. These are antidepressants that would decrease stress-related triggers. Naltrexone, which is used to treat alcoholism, might also be prescribed. Medicine that contained glutame might also work because it controls compulsive behavior. N-acetyl-L-cysteine (NAC) can also be taken as a supplement as it reduces the urge to pull hair.

For someone with Trichotillosis, it is important that the patient receive support. A therapist can give that, but not as much as one's family could. It might also help to join support groups as no one can understand what the patient is going through better than others who are going through the same thing. Trichotillomania can get difficult to cure. However, keep in mind that whenever something goes wrong, the first good step to take is to realize that something is indeed wrong, and then find a cure.