What is Hair Pulling Disease (Trichotillomania)? Causes and Treatment

Hair plucking disease is a condition in which an irresistible urge to pull out hair is seen.

What is Hair Pulling Disease (Trichotillomania)?

Hair pulling disease, also known as trichotillomania, occurs in recurrent episodes. It is a mental disorder that causes an irresistible hair pulling urge. Although trichotillomania patients try to suppress their desire to pluck hair, they cannot succeed and pluck hair, eyelashes or other body hair. Hair plucking disease can cause bald areas on the scalp. This situation can cause patients to experience problems in both social and business life. Trichotillomania patients can grow their hair or apply different solutions to hide these bald areas on the scalp. For some patients, hair pulling is a controllable condition. In some patients, the urge to pluck the hair can be quite strong and may force the patient. Various treatment methods can be tried to reduce or completely eliminate the frequency of hair pulling behavior of patients.
Tricotillomania disease causes many different symptoms to be seen in people. The symptoms seen in hair pulling disease are as follows:

• Repetitively pulling hair on hair, eyebrows, eyelashes (sometimes hair on other parts of the body can also be pulled and the part on which the hair is plucked may change over time)
• Before the hair starts to pluck or Increased tension while resisting the urge to pluck
• The feeling of relaxation and pleasure after plucking the hair
• Length on the scalp, bald areas or shortening of certain parts of the hair
• In eyebrows and eyelashes thinning, empty spaces
• Preferring a specific hair type
• Making hair pulling behavior a ritual
• Bitting, chewing or eating plucked hair
• Playing with the plucked hair or applying the plucked hair to the lips, face
• Trying to stop plucking repeatedly
• Trying to pluck it less often when you can't stop the urge to pluck it
• Being under serious stress in school, work or social life due to hair pulling behavior doll The behavior of plucking hair or fur from animals, pets, blankets, and clothes can also be a sign of trichotillomania. People with trichotillomania usually do their hair pulling behavior when they are alone and try to hide this behavior from other people.
  Hair plucking behavior can be focused or automatic in patients. In focused behavior, the patient consciously plucks his hair. The patient has an irresistible urge to pluck his hair and provides relief by plucking it. Some patients make hair plucking more elaborate, ceremonial. For example, they try to identify the right hair to be plucked or they bite the plucked hair. In automatic behavior, the patient may not even be aware that he is pulling his hair. These patients may cut their hair while watching TV, reading a book or when they are bored. Both focused and automatic hair pulling behavior can be seen in the same patient. The current state and mood of the person is effective on how the behavior will be. Some situations can trigger hair pulling behavior in the person. Combing hair is an example of these situations.
  Tricotillomania can also be related to emotions:
  Negative Emotions: Hair pulling behavior in most trichotillomania patients; It is done to cope with negative emotions such as anxiety, stress, distress, tension, disappointment, loneliness.
  Positive Emotions: Hair pulling behavior in trichotillomania patients leads to a feeling of satisfaction and relaxation. Therefore, patients repeat the hair-pulling behavior to keep feeling these feelings.
  Hair pulling disease is a chronic, long-term disease. The disease may be exacerbated or alleviated from time to time if left untreated. For example, hormonal changes during menstruation in women can cause exacerbation of the symptoms of the disease. In some patients; Untreated, the symptoms of trichotillomania will occasionally disappear and then reappear.

  What are the Causes of Hair Pulling Disease (Trichotillomania)?

  The causes of hair pulling disease have not been fully clarified yet. However, both genetic and environmental factors are thought to be effective in the development of hair pulling disease.
  Even though the causes of trichotillomania are not fully known, familial The risk of this disease is increased in patients with hair pulling disease.
  Hair pulling disease usually occurs in adolescence years. The first symptoms seen in patients are in the form of plucking hair, and patients state that this behavior reduces the feeling of anxiety and stress. At the onset of trichotillomania, patients may not be aware that they are plucking their hair. When the patient realizes this situation, he feels ashamed and his anxiety begins to increase. Increased anxiety causes hair to be plucked again. Therefore, a cycle such as anxiety-hair plucking-temporary relief-embarrassment-re-anxiety-hair plucking occurs in the patient.
  Hair plucking is a mental disorder and may be associated with some other mental conditions. These conditions are:

  • Obsessive Compulsive Disorder (OCD)
  • Anxiety
  • Depression
  • Autism
  • Attention Deficit and Hyperactivity Disorder (ADHD)

  What are the Ways to Get Rid of Hair Pulling Disease?

  First of all, it is necessary to get professional help from a specialist in order to get rid of hair pulling disease. During the treatment process, some applications that the person will make themselves can also help reduce the hair pulling behavior. These applications aim to draw the attention of the patient to another point when the urge to pluck his hair occurs. If the patient wants to tear off his hair;

  • Squeezing stress ball-like objects
  • Exercise his arm muscles by making fists of his hands
  • Using fidget type toys
  • The one who closes the hair wearing a bandana, beanie-style accessories
  • Repeating a set phrase aloud until the urge to pull is gone
  • Taking a relaxing shower to reduce stress and anxiety
  • Plucking hair Breathing deeply until the urge goes away
  • Exercise
  • Having a short haircut
  • May perform practices such as covering the fingertips with sticky objects such as plaster or tape.

  How is the Treatment of Hair Pulling Disease (Trichotillomania)?

  Behavioral therapy and drug therapy can be applied for hair pulling treatment.
  A method called 'habit reversal therapy' can be used in behavior therapy. This method

  • increases the patient's knowledge of trichotillomania symptoms and triggers.
  Helps the patient to replace the hair pulling behavior with another behavior.
  • Finds ways to stay motivated to stop the hair pulling behavior.
  • Helps to use newly learned skills in different situations.
  There are various drugs such as N-acetylcysteine, clomipramine, olanzapine that are thought to be effective in the treatment of trichotillomania. When the doctor deems it necessary, he may prescribe one of these drugs to the patient. If hair pulling disease is not treated, it may cause the development of some complications. These complications are:
  Emotional Distress: Many trichotillomania patients have been reported to feel shame and humiliation. This may cause problems such as lack of self-confidence, depression, anxiety, alcohol and substance use in patients.
  Problems in Social Life and Work Life: Open, bald areas on the scalp may cause embarrassment. For this reason, the person may stay away from social activities and job offers. A person may avoid intimacy with other people for fear of being noticed in his private life. Hair growth in the areas where the hair is plucked may stop permanently.
  Trichobezoar: Eating the plucked hair causes the formation of hairballs called trichobezoars in the digestive tract. These hairballs can cause serious consequences such as vomiting, weight loss, intestinal obstruction and even death over time.
  Hair plucking is a mental disorder. In cases where the patient is not treated and the necessary support is not given, trichotillomania can have serious consequences. For this reason, people who have behaviors such as hair pulling and hair eating should definitely consult a specialist.

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