Trichotillomania: Definition, Symptoms, Causes, Effect, And Treatment (2024)

Trichotillomania is a mental health condition characterized by the compulsive urge to pull out one’s hair. This urge is often accompanied by a feeling of tension or stress that is relieved upon pulling out the hair.

Symptoms of trichotillomania can vary from person to person, but common signs include repeated hair pulling, attempts to resist the urge, and noticeable hair loss or bald patches. Individuals may also experience feelings of shame, guilt, and anxiety related to their hair pulling.

The causes of trichotillomania are not fully understood, but it is believed that a combination of genetic, environmental, and psychological factors may contribute to its development.

The effects of trichotillomania can be significant and include social anxiety, low self-esteem, and physical damage to the scalp. In some cases, hair pulling can also lead to skin infections or scarring.

Treatment for trichotillomania typically involves a combination of therapies, such as CBT, habit reversal training, and medication. The goal of treatment is to help individuals gain control over their hair-pulling and reduce the associated distress.

This article has been enhanced with input from the Medical Director and Addiction Psychiatrist at Valley Spring Recovery Center, Dr. Michael Olla.

Check the end of each section for extra information from him.

What is Trichotillomania?

Trichotillomania is a chronic mental health condition characterized by the urge to pull out one’s hair, leading to noticeable hair loss and distress. American Psychiatric Association (APA) classifies Trichotillomania as an Obsessive-Compulsive and Related Disorder in the DSM-5 and typically begins in early childhood.

According to the International OCD Foundation (IOCDF), Trichotillomania involves repetitive hair-pulling that provides a sense of relief, but it is a mental health disorder that requires professional treatment, not just a habit.

According to the Anxiety and Depression Association of America, ADAA, affects individuals of all ages and genders, with an estimated 5-10 million Americans being affected. It is more common in females than males and can range from mild hair or eyelash pulling to severe cases involving baldness, disfigurement, and chronic skin conditions. The onset of TTM can occur as early as 22 months of age, with no recorded onset over 60 years of age. It may also start at the preteen stages due to hormonal changes. While social media may not significantly impact the development of TTM, it can promote self-awareness and encourage individuals to seek professional help.

“Trichotillomania is a complex disorder where individuals experience a cycle of stress and anxiety that leads to hair pulling. This behavior provides a temporary sense of relief, but as bald spots start to appear, the visible signs of hair loss often intensify feelings of distress. This creates a reinforcing loop where the anxiety about bald spots exacerbates the urge to pull, perpetuating the cycle of hair pulling and psychological discomfort.”

Dr Michael Olla

What is the difference between trichotillomania and Obsessive Compulsive Disorder?

Trichotillomania and Obsessive-Compulsive Disorder (OCD) are both types of obsessive-compulsive and related disorders, but they can affect individuals differently.

Trichotillomania is the irresistible urge to pull out hair from the body, which is triggered by tension or anxiety and provides a feeling of relief or pleasure. This behavior leads to distress in various aspects of life.

Obsessive-Compulsive Disorder (OCD) involves unwanted thoughts and repetitive behaviors that people feel compelled to perform, such as excessive hand-washing, in response to anxiety.

However, both involve compulsive behaviors to reduce anxiety or stress. The key distinction is that trichotillomania specifically involves hair-pulling, while OCD can involve various compulsions in response to intrusive thoughts.

How is Trichotillomania related to Skin-Picking Disorder?

Trichotillomania and skin-picking disorder are related body-focused repetitive behaviors (BFRBs), characterized by repetitive hair-pulling and skin-picking, respectively, despite attempts to stop. Both disorders are in the DSM-5, sharing clinical profiles, impairment levels, and dampened autonomic responses to pain.

Trichotillomania is a compulsive urge to pull out hair, causing visible hair loss and distress, often triggered by stress or anxiety.

Skin-Picking Disorder, also known as Excoriation Disorder, is a condition characterized by the compulsive act of picking at one’s skin, often leading to skin lesions and mental distress. Individuals affected by this disorder may pick at healthy skin, minor skin imperfections, or scabs, resulting in open sores and infections. This behavior can significantly impact one’s quality of life and emotional well-being.

They frequently co-occur, suggesting a possible shared underlying mechanism. Individuals with both trichotillomania and skin-picking disorder exhibit a significant positive correlation between hair-pulling and skin-picking severity.

Both disorders commonly present with co-occurring depression, anxiety, and obsessive-compulsive symptoms. The severity of hair-pulling and skin-picking peaks during the transition to adulthood.

Self harming behavioral addictions and mental health conditions similar to trichotillomania are listed below.

How is Trichotillomania Related to Other Compulsive Behaviors That Cause Self Injury?

Self-injury is a mental health-related behavior people engage in to feel pain because they feel numb, to experience physical pain to ease their psychological pain, or to experience an emotional release. Self-injury addiction disorders frequently co-occur, suggesting shared underlying mechanisms such as difficulty in managing stress, emotional dysregulation, and obsessive-compulsive traits. Harmful compulsive behaviors are common in patients with other co-occurring anxiety or mood disorders. An addictive component to self-injury has been identified related to an increase in dopamine levels from the self-injury, which then disrupts normal dopamine production similar to substance use disorders according to Worley J.’s 2020 study on Self-Injury as an Addictive Disorder. Trichotillomania is classified as an obsessive-compulsive and related disorderin the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and not a behavioral addiction, although it is related in nature.

Exercise Addiction

Exercise addiction, also known as exercise dependence, is characterized by an unhealthy obsession with physical fitness and exercise. Trichotillomania and exercise addiction are related behavioral disorders, characterized by compulsive hair-pulling and excessive exercising, both resulting in physical pain and dopamine rush from the act. Individuals with this addiction often feel compelled to engage in excessive exercise, prioritizing it over other important aspects of life, such as work, relationships, and health. This compulsion is driven by the need to achieve a sense of control, cope with stress, or attain a desired physical appearance. Excercise addiction is related to trich

Symptoms include:

• Exercising despite injury or illness
• Experiencing withdrawal symptoms when unable to exercise
• Neglecting social, occupational, or academic responsibilities in favor of exercise
• Feeling anxious or guilty if exercise routines are not followed

Exercise addiction can lead to serious physical and psychological consequences, including chronic injuries, cardiovascular problems, and mental health issues such as anxiety, depression, and body dysmorphic disorder. It often co-occurs with eating disorders, as both conditions involve a preoccupation with body image and control.

Eating Disorders

Eating disorders are severe mental health conditions characterized by abnormal eating habits that negatively affect physical and mental health. The most common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.

• Anorexia Nervosa: Characterized by an intense fear of gaining weight and a distorted body image, leading to extreme food restriction and excessive weight loss. Individuals with anorexia often perceive themselves as overweight even when they are underweight. This disorder can result in severe malnutrition, heart issues, and even death.
• Bulimia Nervosa: Involves cycles of binge eating followed by purging behaviors such as vomiting, excessive exercise, or the use of laxatives. Bulimia can cause gastrointestinal problems, severe dehydration, and heart complications due to electrolyte imbalances.
• Binge-Eating Disorder: Characterized by recurrent episodes of eating large quantities of food, often rapidly and to the point of discomfort. Unlike bulimia, binge-eating episodes are not followed by purging. This disorder can lead to obesity, diabetes, and cardiovascular diseases.

Eating disorders often co-occur with other mental health issues and is triggered by anxiety, depression, and obsessive-compulsive disorder (OCD) similar to Trichotillomania.

Body Dysmorphic Disorder (BDD)

Body dysmorphic disorder is a mental health condition where individuals obsess over perceived flaws in their appearance, which are often unnoticeable to others. This preoccupation can lead to significant distress and impair daily functioning. People with BDD may spend excessive time checking mirrors, grooming, or seeking reassurance about their appearance. They often undergo unnecessary cosmetic procedures, which rarely alleviate their distress.

BDD frequently co-occurs with anxiety disorders, depression, and OCD. The distress and impairment caused by BDD can be severe, leading to social isolation, academic or occupational dysfunction, and an increased risk of suicidal behavior.

Self-Harm (Cutting)

Self-harm, particularly cutting, is a behavior where individuals deliberately inflict harm on their bodies, often as a way to cope with emotional pain, stress, or trauma. This behavior provides temporary relief from emotional distress but can lead to severe physical injuries, infections, and long-term psychological consequences.

Self-harm is associated with a range of mental health disorders, including depression, anxiety, borderline personality disorder, and PTSD. It is crucial to address the underlying psychological issues through therapy and support to reduce the occurrence of self-harm behaviors.

What are the Signs and Symptoms of Trichotillomania?

Signs and symptoms of Trichotillomania include repeatedly pulling out hair, whether it’s automatic or on purpose, often resulting in bald patches. People with trichotillomania may feel tension before pulling out their hair, and experience relief afterward. They may also have difficulty stopping or decreasing the behavior, and engage in rituals related to pulling hair.

This list details the common signs and symptoms of trichotillomania, helping you understand the different ways this condition can present itself.

• Repeatedly pull out hair: People with Trichotillomania repeatedly pull out their hair, whether intentionally or unintentionally, usually from their scalp, eyebrows, or eyelashes, but also from other body areas.
  
• Experience increasing tension before pulling: Individuals with this condition may feel a growing sense of tension before pulling out their hair, or when they attempt to resist the urge.
  
• Feel pleasure or relief after pulling: After pulling out hair, they often experience a sense of pleasure or relief. A study was done by Lochner C, Grant JE, Odlaug BL, and Stein DJ. (2012). DSM-5 field survey: hair-pulling disorder (trichotillomania). Depress Anxiety highlighted that diagnostic criteria focused on “urge,” “tension,” “need,” “drive,” or “impulse” to pull, or pleasure, gratification, or relief during or after pulling, were endorsed by many, but not all participants. Individuals who did endorse such criteria had significantly more severe hair-pulling symptoms.
  
• Experience noticeable hair loss: Trichotillomania causes visible hair loss, such as shortened hair or thinned or bald areas on the scalp or other body areas. Individuals with Trichotillomania often exhibit repetitive hair-pulling behavior, leading to noticeable hair loss or tissue damage, According to Grant et al.’s 2023 study “Double-Blind Placebo-Controlled Study of Memantine in Trichotillomania and Skin-Picking Disorder.
  
• Repeatedly attempt to stop: Individuals with Trichotillomania often try to stop or reduce hair pulling but fail to do so. According to the 2012 study “DSM-5 field survey: hair-pulling disorder (trichotillomania)” by Christine Lochner et al., in the DSM-5 diagnostic criteria for hair-pulling disorder (HPD), or trichotillomania, most (n = 82 [98%]) reported repeated attempts to decrease or stop hair-pulling.
  
• Experience distress or problems in social situations: The condition causes significant distress or problems in social, work, or school settings. People with trichotillomania may feel frustrated, ashamed, and embarrassed due to their hair loss. They may experience low self-esteem, depression, anxiety, and problems with alcohol or drugs. This can cause difficulties in social life and with work.
  
• Emotional and Behavioral Symptoms: Individuals with trichotillomania often struggle with emotional turmoil, including guilt, shame, and anxiety. They may exhibit behavioral patterns such as social avoidance, using disguises to conceal hair loss, or obsessing over hair-pulling activities. According to Travis O Bruce et al.’s 2005 study “Diagnosis and management of trichotillomania in children and adolescents”, Trichotillomania (TTM) is a disorder that can be associated with serious social and psychological dysfunction, as well as medical problems.

What are the Causes of Trichotillomania?

The causes of trichotillomania are not fully understood. Experts believe it is related to a combination of genetic and environmental factors. Stress, anxiety, and boredom can trigger the hair-pulling, which may be a way of coping with negative feelings. Additionally, other mental health disorders such as obsessive-compulsive disorder (OCD), ADHD, and autism can contribute to the development of trichotillomania.

The causes of trichotillomania are listed below:

• A chemical imbalance in the brain: Neurotransmitter dysfunctions play a pivotal role in the development of trichotillomania. According to Isaac, Thomas Gregor et al.’s 2018 study “Trichotillomania Ranging from ‘Ritual to Illness’ and as a Rare Clinical Manifestation of Frontotemporal Dementia,” serotonin imbalances are implicated, influencing compulsive hair-pulling behaviors. This condition, often responsive to SSRIs and N-acetyl cysteine, underscores neurotransmitter modulation’s therapeutic potential in managing trichotillomania.
  
• Genetic Factors: Genetic factors play a significant role in the development of Trichotillomania, Variants in certain genes, such as the dopamine receptor type 4 gene (DRD4), may contribute to the disorder according to Sîan M J Hemmings et al.’s 2004 study “Early- versus late-onset obsessive-compulsive disorder: investigating genetic and clinical correlates”, early-onset OCD appears to be a subtype that exhibits distinct clinical features and is associated with greater familial loading.

  The study also found an association between early age of onset and an increased frequency of tics, Tourette’s disorder, and trichotillomania (TTM).

  Also According to Novak, C. E., Keuthen, N. J., Stewart, S. E., & Pauls, D. L. (2009). A twin concordance study of trichotillomania. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics – the concordance rates for same-sex twin pairs with hair pulling suggest that genetic factors play a significant role in the etiology of trichotillomania, with a heritability estimate of 76.2%.

  See Also

  6.5: Eating Disorders

• Anxiety disorders/Depression: Anxiety disorders can cause trichotillomania, with depression also frequently accompanying the disorder. According to Grant, Jon E. et al.’s 2017 study “Trichotillomania and co-occurring anxiety”, trichotillomania is often associated with co-occurring anxiety disorders. The study found that participants with trichotillomania and co-occurring anxiety reported significantly worse hair-pulling symptoms, were more likely to have co-occurring depression, and were more likely to have a first-degree relative with obsessive-compulsive disorder.

  In Lewin, A. B. et al.’s 2009 study “Depression, anxiety, and functional impairment in children with trichotillomania”, over 45% of children with trichotillomania endorsed depressive symptoms and 40% endorsed anxiety symptoms over one standard deviation above published community norms.

• Body dysmorphia: Body dysmorphic disorder (BDD) has been linked to Trichotillomania, a compulsive behavior characterized by the urge to pull out one’s hair, often resulting in significant emotional distress and social impairment.

What are the Effects of Trichotillomania?

Trichotillomania can cause both physical and emotional effects. It frequently results in patchy bald spots, which can cause significant distress and affect a person’s social life and work. Additionally, hair pulling can damage skin tissue, potentially leading to infection, especially if tweezers or other sharp objects are used.

Trichotillomania can be dangerous to your loved ones too. According to De Sousa, A. (2015), Trichotillomania is characterized by an intense urge to pull hair, resulting in hair loss on the scalp, eyebrows, and pubic areas. The study, “Trichotillomania by Proxy,” highlights a case where a mother with a history of trichotillomania pulled her child’s hair as a release for her urges. This case highlights the potential for physical damage inflicted on a child by a parent with Trichotillomania.

These effects of trichotillomania are listed below.

• Physical Damage: According to Schumer, Maya C. et al.’s (2015) study “Long-Term Outcome in Pediatric Trichotillomania,” trichotillomania, a disorder characterized by recurrent hair pulling, can lead to significant hair loss and distress. Individuals with trichotillomania may experience physical damage from repetitive hair pulling, including scalp irritation, follicle damage, and in some cases, skin infections.
• Emotional Distress: Trichotillomania causes feelings of shame and guilt, and a study by Grant and R. found that 79% of individuals with this disorder have at least one additional mental health condition, such as low self-esteem, depression, anxiety, or ADHD.
• Social Isolation: Trichotillomania can cause social isolation by leading to noticeable hair loss that can cause distress and shame. This can make people with trichotillomania feel uncomfortable socializing, which in turn can lead to social isolation. People with trichotillomania may avoid social situations or go to great lengths to hide their hair loss.
• Disturbance in Daily Activities: Trichotillomania can cause disturbance in daily activities. It impacts routines, social interactions, and work or school performance due to preoccupation with hair-pulling urges.

What are the physical health implications of Trichotillomania?

Trichotillomania can lead to physical health issues like scarring, infections, and damage to the skin on the scalp or where hair is pulled. Pulling hair repeatedly can cause bald spots and even more emotional distress. If someone chews or swallows pulled hair, it can form a “ball” of hair that can lead to stomach pain and other health problems.

How can Trichotillomania affect your mental health?

Trichotillomania can negatively impact mental health by increasing the risk of developing other mental health issues like anxiety, mood disorders, and personality disorders. These feelings can create a vicious cycle, leading to social isolation, anxiety, and even depression.

According to Franklin, M. E. et al.’s (2011) review article ‘Trichotillomania and its treatment: a review and recommendations’, individuals with trichotillomania (TTM) are at a higher risk of experiencing psychiatric comorbidity across the developmental spectrum.

Also, another study from Grant, Jon E. et al.’s 2017 study ‘Trichotillomania and Co-occurring Anxiety’ published in Comprehensive Psychiatry, found individuals with trichotillomania often experience feelings of shame and embarrassment regarding their condition, which can further exacerbate mental health issues.

How is Trichotillomania Diagnosed?

Trichotillomania is diagnosed by a healthcare professional, typically a psychiatrist or dermatologist. Screening tests may be conducted to rule out other conditions. The evaluation may involve a punch biopsy and computerized tomography (CT) Scan of the scalp to visualize hair regrowth patterns microscopically.

Punch Biopsy

A punch biopsy is a minor procedure where a healthcare provider takes a small sample of skin from the scalp for lab analysis. This procedure helps confirm a diagnosis of trichotillomania. The biopsy can reveal increased numbers of catagen follicles, pigment casts in hair canals, and empty anagen follicles common in trichotillomania. A punch biopsy is a minor procedure where a healthcare provider takes a small sample of skin from the scalp using a special tool called a punch. The procedure is typically done under local anesthesia, and it is usually painless.

Computerized tomography (CT) Scan

A CT scan is a non-invasive imaging technique that combines X-rays and computer technology to create detailed cross-sections of the body, including the brain. It can help identify abnormalities related to impulse control and obsessive behaviors, mainly focusing on the frontal cortex and basal ganglia.

s Trichotillomania a Type of Self-Harm?

Trichotillomania is not a type of self-harm. The intention of hair-pulling is not to hurt oneself. While it can cause damage to the hair, skin, or nails, the motivation for pulling is not self-harm but rather an obsessive compulsion. Trichotillomania is classified as an impulse control disorder, distinct from self-harm.

Is Trichotillomania Contagious?

Trichotillomania is not contagious. It is a mental health condition that affects an individual’s urge to pull out their hair. Trichotillomania is not a result of a virus or bacteria, and it cannot be spread from person to person.

How long does Trichotillomania last?

Trichotillomania, also known as hair-pulling disorder, can persist for many years, impacting individuals throughout their lives. However, 24.9% of individuals with lifetime trichotillomania experienced natural recovery, meaning they no longer had symptoms without therapy or medication, according to Grant, J. E., & Chamberlain, S. R. (2022). Natural recovery in trichotillomania. Australian and New Zealand Journal of Psychiatry. The study conducted by Grant and Chamberlain in 2022 utilized a convenience sample of approximately 10,169 individuals representative of the general US population, 18-69 years of age, to examine natural recovery in trichotillomania.

This research found that natural recovery from trichotillomania was associated with significantly lower rates of related comorbidities such as obsessive-compulsive disorder (OCD), attention-deficit hyperactivity disorder (ADHD), panic disorder, skin picking disorder, and tic disorder.

Is Trichotillomania a disease?

Trichotillomania is not a disease, but rather a mental health disorder classified as an impulse control disorder. This means that individuals with trichotillomania experience difficulty resisting the urge to pull out their hair, even though they know it is harmful.

The disorder is officially recognized and included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the standard reference book used by mental health professionals to diagnose mental disorders.

Is Trichotillomania genetic?

Individuals with a family history of trichotillomania or related conditions like obsessive-compulsive disorder (OCD) may have a higher chance of developing the condition themselves. However, it’s important to remember that genetics are not the sole determinant of whether someone will develop trichotillomania. Other factors, such as environmental triggers and individual personality traits, also play a role.

Trichotillomania (TTM) is likely influenced by genetic factors, with research suggesting a connection to the 5-HT2A gene, which plays a role in serotonin signaling and impulse control according to Hemmings, Sîan M. J., et al. “Genetic correlates in trichotillomania–A case-control association study in the South African Caucasian population.

Is Trichotillomania a part of anxiety?

Trichotillomania is a disorder, not a part of anxiety. While it’s often associated with anxiety, they are distinct conditions.

Is Trichotillomania included in the DSM-5?

Yes, Trichotillomania is included in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). It is classified within the obsessive-compulsive and related disorders section. Previously, it was classified as an impulse control disorder in the DSM-IV.

Is Trichotillomania a choice?

Trichotillomania is not a choice. It is a mental health disorder characterized by a compulsive urge to pull out one’s hair.

What are the Types of Trichotillomania Treatment?

Trichotillomania treatments include Cognitive Behavioral Therapy (CBT), Habit Reversal Training (HRT), therapy (individual, family, or support group), managing stress, exercising, deep breathing, and medications, although no specific ones are approved for this condition. Combining therapy, medication, and lifestyle changes like managing stress, exercising, deep breathing, and mantra can help people manage trichotillomania.

Here are the treatments for trichotillomania below:

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is considered a highly effective treatment for trichotillomania. This therapy assists individuals in recognizing and restructuring negative thought patterns and actions connected to hair-pulling. Frequently, CBT incorporates Habit Reversal Training (HRT), which educates patients on alternative behaviors to replace hair-pulling. Nevertheless, this therapy can be lengthy and necessitates a qualified therapist to be effective.

According to Snorrason, Ivar et al.’s 2015 review article “Optimizing psychological interventions for trichotillomania (hair-pulling disorder): an update on current empirical status,” published in the journal “Psychological Research and Behavior Management,” several authors have successfully augmented traditional behavioral strategies with other cognitive-behavioral interventions, such as cognitive therapy, dialectical behavioral therapy, and acceptance and commitment therapy.

Habit Reversal Training

Habit Reversal Training (HRT) is a behavioral therapy that helps people with trichotillomania (hair-pulling disorder) learn to identify and change their hair-pulling behavior. It focuses on understanding the triggers, replacing the hair-pulling with a different behavior, and developing coping strategies. HRT aims to reduce the frequency and intensity of hair-pulling episodes by developing awareness and building coping skills.

HRT consists of awareness training, self-monitoring, stimulus control, and competing response procedures, which help clients recognize their urges, avoid triggering situations, and adopt alternative behaviors.

Therapists work with individuals to identify situations and feelings that lead to hair-pulling. They then teach clients to recognize these triggers and develop a plan to replace the hair-pulling with a different behavior. This may involve using a physical reminder, engaging in a distracting activity, or practicing relaxation techniques.

According to Rahman, Omar et al.’s 2017 study ‘Preliminary Randomized Controlled Trial of Habit Reversal Training for Treatment of Hair Pulling in Youth’, youth participants (N = 40, 85% female) diagnosed with TTM were randomly assigned to either 8 weekly sessions of HRT or 8 weeks of TAU. The HRT group showed significant reductions in hair-pulling frequency and severity compared to the TAU group. The study indicated that HRT was associated with a statistically significant decrease in hair-pulling behavior.

Trichotillomania Support Group

Trichotillomania support gatherings offer a sense of camaraderie and empathy to those involved, as they exchange experiences and techniques for dealing with similar circ*mstances. These groups can provide emotional backing, alleviate feelings of solitude, and give practical counsel on how to handle hair-pulling tendencies. The key benefits of these support groups include mutual assistance, acceptance, and affirmation.

Stress Management

Stress management techniques can be effective in managing trichotillomania in adults. Stress often triggers hair-pulling behavior. Learning stress management techniques like deep breathing, yoga, or mindfulness can aid in controlling hair-pulling urges. Stress management is often integrated into therapy for trichotillomania.

Deep Breathing

Practicing deep breathing exercises can aid in managing the persistent impulse to pull hair, as they promote relaxation and help alleviate anxiety. Techniques such as diaphragmatic breathing or the 4-7-8 method can be conveniently practiced in various situations and at any time. Nonetheless, deep breathing alone may not be sufficient as a standalone treatment for more severe instances of trichotillomania.

Exercise

Regular physical activity is advantageous for managing trichotillomania, as it assists in decreasing stress and anxiety, which are key triggers of hair-pulling behaviors. Engaging in various forms of exercise, such as jogging, yoga, weightlifting, cardiovascular workouts, or participating in team sports, can help alleviate tension and enhance overall well-being. Nonetheless, it is essential to allocate the necessary time and maintain the motivation to consistently follow an exercise routine.

Mantra

Adopting a mantra involves regularly repeating a soothing word or expression to yourself to redirect your focus away from the impulse to tug at your hair and alleviate tension. This method can be employed during instances of strong desire or nervousness. The benefit of employing a mantra is its simplicity and the capability to supply immediate mental respite. Nevertheless, it might be necessary to pair mantra use with other treatment approaches for optimal results, such as physical activity, deep breathing exercises, or medication.

Medication

There is no single best medication for trichotillomania. Treatments for trichotillomania often involve a combination of therapy and medication. Medications used to treat trichotillomania include selective serotonin reuptake inhibitors (SSRIs) and antidepressants.

What Medications Are Used to Treat Trichotillomania?

Trichotillomania typically requires a multifaceted approach to treatment, including medication. While there’s no single medication specifically approved for trichotillomania, several classes of drugs can help manage its symptoms and underlying conditions.

Treatment with N-acetylcysteine (NAC) may lead to dramatic improvement within 6 months. According to Popova, L. and Mancuso, J.’s 2022 case study, “Dramatic Improvement of Trichotillomania with 6 Months of Treatment With N-Acetylcysteine”, a 17-year-old male with trichotillomania experienced significant hair regrowth and reduced urges to pull his hair after 6 months of treatment with NAC.

Commonly used medications for trichotillomania:

1. Serotonin Reuptake Inhibitors (SSRIs):

• Function: Increase serotonin levels in the brain, which can help regulate mood, anxiety, and impulsivity, all of which play a role in trichotillomania.
• Side effects: Can include nausea, insomnia, sexual dysfunction, and weight gain.

2. Antipsychotics:

• Function: Primarily used for severe cases of trichotillomania with psychotic symptoms, these medications help regulate dopamine and serotonin activity in the brain.
• Side effects: Side effects can include weight gain, drowsiness, and movement disorders.

3. Anticonvulsants:

• Function: Primarily used for epilepsy, these medications can also help regulate brain activity and reduce impulsivity.
• Side effects: These can include cognitive difficulties, fatigue, and mood changes.

4. N-Acetylcysteine (NAC):

• Function: This amino acid supplement helps regulate glutamate levels in the brain, which may play a role in compulsive behaviors like trichotillomania.
• Side effects: Generally well-tolerated, but can cause mild gastrointestinal issues.

For effective management of trichotillomania, consulting a healthcare professional is essential. They can prescribe appropriate medication based on individual requirements and medical history. While medication often complements therapy, it may take several weeks to observe noticeable effects. Patience and consistent treatment are crucial. Discussing potential side effects with the healthcare professional allows for adjustments in medication or dosage as needed.