• Thomas
  • Dec 26, 2018

Trichotillomania A Treatable Disease

The definition of Trichotillomania is persons that compulsively pull their hair follicles from their arms, scalp, eyelashes, leg, or even the pubic region. This compulsion leads to completely pulling the root to the point of   irreversible hair loss thereby creating bald areas on the affected area.


Furthermore, and unfortunately; infants are afflicted with this disorder, however it is commonly diagnosed in adolescents and adults. Moreover, race or age is not a factor. Having said this, there are two main subtypes or groups of Trichotillomania. One is a focused type 1 and then there is an Automatic subtype 2. Let us discuss these.


Stressors and/or depression play a factor in the first of the two sub-types. For example, Jessica is having excessive stress over the Christmas holidays this year because her mother passed away recently. Jessica stares at her mother’s sewing machine that sits in her living room. She begins to pull on the frontal hairline and rocks to and fro at the same time.  She pulls and pulls until a few strands of her hair pulls completely out. Doctors believe that the act of pulling on the hair until it finally is pulled out provides a gratification. It seems that a cutter is in the same category because they too get gratification from the act of cutting.

Sub Type II

Besides the the sub type Focused, Automatic trichotillomania is the second type of trichotillomania. This sub type is where a person is unaware that they are pulling their hair. If fact it is of as a day dreaming and just as in Focused, they continually pull the hair until it comes out.

Actually, children seem to fall into the category of the automatic or the unconscious type of trichotillomania. Often children are seen to be in a “trance-like” state and most often they literally do not realize the repercussions of this irreversible hair loss. Moreover, children mainly pull hair from the scalp and not secondary areas.  Additionally In severe isolated cases a “sleep-isolated trichotillomania” is where an individual will pull out their hair during sleep. Most children outgrow this disorder.

Sometimes the hair pulling goes in a manic form where the individual will suddenly pull his/her hair for hours, days months. Other times the hair pulling rituals stop and do not occur for hours, days, or months. This disorder can be associated with other problems such as anxiety, post traumatic disorder, depression and/or obsessive compulsive disorder. There may be a genetic tie as well.


Finally, A hair transplant can be used to treat this disorder, however a full year of psychiatric treatment as well as a full year of no pulling must be completed at most experienced and fully disclosing clinics. Then it would be ok to transplant the affected area.


More information found at the MAYO Clinic in Minnesota.

Thomas Ortiz

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