Trichotillomania is a mental disorder that makes sufferers have an irresistible urge to pull out the hair on their head . Trichotillomania sufferers also have the urge to pull out hair on other parts of the body, such as the eyebrows and eyelashes.

Generally, people with trichotillomania have the urge to pull out their hair when experiencing stress or anxiety. Sufferers believe, pulling his hair can relieve stress or anxiety he experienced. This habit is very difficult to get rid of, even though the sufferer knows it is not good for him.

Trichotillomania can cause patchy hair loss. As a result, sufferers will be embarrassed and try to cover it up by avoiding other people. Sufferers will also feel depressed because they feel they have bad and strange habits.

With fast and appropriate treatment, trichotillomania can be reduced or stopped. Otherwise, this condition has the potential to cause mental disorders or skin damage .

Trichotillomania Causes and Risk Factors

The exact cause of trichotillomania is not known with certainty. Some experts argue that this condition is related to environmental and hereditary factors. In addition, there are several factors that can increase a person's risk of experiencing trichotillomania, namely:

  • 10–13 years old
  • Have a family history of trichotillomania or other mental disorders
  • Have another mental disorder, such as obsessive compulsive disorder (OCD), anxiety disorder, or depression
  • Experiencing situations or events that cause pressure or stress
  • Have other bad habits, such as thumb sucking or nail biting
  • Suffering from a disease caused by a nervous system disorder, such as Parkinson's disease or dementia
  • Have abnormalities in the structure and metabolism of the brain

Symptoms of Trichotillomania

The following are the symptoms and signs that appear in sufferers of trichotillomania:

  • Pulling hair repeatedly, whether on the head, eyebrows, or other areas of the body
  • Feeling anxious before pulling your hair or when refraining from doing it
  • Feel satisfied and relieved after hair removal
  • Have a certain kind of habit that is always done before pulling hair, for example choosing hair to be pulled out
  • Never managed to resist the urge to pull out the hair
  • Playing with or rubbing hair that has been removed on certain areas of the body, such as the face or lips
  • Experiencing social disturbances and difficulties

In some cases, people with trichotillomania can also have other disorders, such as the habit of picking at the skin, biting their fingernails ( onycophagia ), or biting their lips. People with trichotillomania can also have a habit of pulling out animal hair, doll hair, or threads from clothes.

Symptoms of trichotillomania can appear when sufferers feel tense or stressed. However, sometimes symptoms can appear unnoticed.

When to see a doctor

Check with your doctor if you continually pull your hair, especially if you've tried to stop yourself from doing it again.

Immediately to the doctor if you have a habit of eating hair that has been removed (Rapunzel syndrome). This should not be allowed, because eaten hairballs can clog the intestines.

Trichotillomania diagnosis

To diagnose trichotillomania, the doctor will ask questions and answers about the symptoms experienced by the patient, as well as the patient's and family's medical history. Next, the doctor will examine the parts of the patient's body where hair is frequently pulled and how much the patient loses his hair.

Doctors can confirm the diagnosis of trichotillomania in patients who have the following criteria:

  • The habit of pulling hair continuously, until you experience hair loss
  • Difficulty stopping and holding back hair pulling
  • The habit of pulling hair to cause disturbance and difficulty in social life
  • Habitual hair pulling is not caused by a disease of the hair or skin
  • The habit of pulling hair is not caused by another mental disorder, the symptom of which is pulling hair

If needed, the doctor may perform a biopsy (taking a tissue sample) to identify other causes of hair loss, such as a scalp infection.

Trichotillomania Treatment

The goal of trichotillomania treatment is to reduce or stop sufferers from pulling their hair. Some of the treatment methods that can be done are:


Psychotherapy to treat trichotillomania is carried out in the form of psychological therapy with a psychiatrist . This method will focus on changing the patient's behavior by diverting the action of pulling hair into an activity that has no bad impact.

The patient will be asked to observe and identify when and where the urge to pull out the hair occurs. After that, the patient will be directed to be able to calm down when the urge appears and replace it with another activity so that the urge to pull out the hair is distracted and disappears.

Some ways that people with trichotillomania usually use to divert urges include:

  • Squeezing a stress ball or similar object
  • Playing an instrument that diverts anxiety, such as the fidget cube
  • Saying or shouting a sentence or word repeatedly, for example counting 1, 2, 3, and so on
  • Take a bath or bath in a relaxing atmosphere to relieve feelings of restlessness or anxiety that arise
  • Learn breathing techniques to calm and relieve symptoms when they flare up
  • Exercise regularly
  • Cut hair short


Apart from therapy, doctors can also give antidepressant drugs belonging to the serotonin reuptake inhibitor (SSRI) class to relieve the symptoms of trichotillomania. These drugs can be used alone or in combination with antipsychotic drugs , such as olanzapine and aripiprazole .

It is important to remember, the dose of using SSRI drugs in each trichotillomania patient depends on the age and severity of the condition. Therefore, the use of this drug must be in accordance with a doctor's prescription.

Trichotillomani complications a

Trichotillomania sufferers who do not undergo proper therapy can experience complications in the form of:

  • Disturbances in social life, due to shyness or lack of self-confidence
  • Skin damage due to hair pulling, in the form of scars or permanent baldness
  • Other mental disorders, such as depression

In trichotillomania patients who also experience Rapunzel syndrome, another complication that can occur is impaired digestive tract function. This condition can cause weight loss and blockage of the intestines.

Prevention of Trichotillomania

There are no proven efforts to prevent trichotillomania. However, understanding how to manage stress can help reduce the risk of developing trichotillomania. The following are some ways to manage stress:

  • Get used to seeing things from the positive side
  • Learn to understand that there are some things you can't control
  • Don't harbor feelings or opinions
  • Learn relaxation methods, such as yoga
  • Exercise regularly
  • Eat a healthy and nutritionally balanced diet
  • Learn to be disciplined and have good time management
  • Dare to refuse requests that can trigger stress (be assertive )
  • Make free time for an interesting hobby or activity
  • Provide adequate time for sleep and rest
  • Don't rely on alcohol or drugs to relieve stress
  • Seek social support and spend time with someone who is comfortable
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