What is Trichotillomania?
Trichotillomania (TTM or trich) is a disorder characterized by recurrent pulling out of one’s hair from the scalp, eyebrows, eyelashes, and other areas of the body, often causing bald patches. Pulling is most common during sedentary activities but varies greatly in its severity. While some individuals report they are very aware or their pulling, others explain that their pulling is almost subconscious. In the United States, approximately two to ten million people have trich (2-5% of the population). People of all ages and backgrounds have trich; however by adulthood most reported cases are women.
What Causes Trich?
Unfortunately, the cause of trich is unknown. However, it is believed that trich is a neurological disorder and may even be genetic. So no one is to be blamed for trich, neither the individual with trich nor the parents are responsible for making it happen. Many people are misinformed and believe that pulling is a sign of self-mutilation, trauma, or poor parenting. However, the truth is that trich can occur in happy, well-adjusted people. Trich is just as likely to be associated with emotions such as boredom as it is with stress or anxiety. It can be triggered by sensory events, such as itchy scalp, or be stressful life events. In either case, pulling frequently serves as a way to cope or soothe.
Is There Treatment for Trich?
Trich is more than just a habit and believing that one can use will-power to control it is not likely to be effective. Without treatment, trich tends to chronically wax and wane throughout one’s life. However, many people have learned to manage their symptoms and gain more control. Comprehensive cognitive-behavioral treatment for trich has shown to be the most successful treatment for trich known today. This treatment includes:
- Education about trichotillomania
- Creating a tailored treatment plan based on the individual
- Developing an increased awareness of pulling habits
- Identifying factors that trigger pulling including both internal and external cues
- Learning skills and alternative behaviors to interrupt and redirect responses to triggers
- Utilizing more productive sensory and coping substitutes to meet needs in the situation
- Challenging thought patterns related to pulling
What Resources are Available?
Although trich is a problem many people do not talk about, there are some great resources available to help not only with education but with reducing the stigma related to trich. The TLC Foundation for Body-Focused Repetitive Behaviors (https://www.bfrb.org/) is a national nonprofit organization aimed at education and support. Some helpful books also include:
“Stay Out of My Hair! Parenting Your Child with Trichotillomania” by Mouton-Odum and Golomb
“The Hair Pulling Habit and You: Solving the Trichotillomania Puzzle” by Golomb and Vavrichek
“The Hair Pulling Problem: A Complete Guide to Trichotillomania” by Penzel