Trichotillomania is a mental health condition marked by an ongoing urge to pull out one’s hair, even when the individual tries to resist the behavior.
Key indicators include repetitive hair-pulling, often tied to specific rituals or preferences. Many individuals attempt to conceal the behavior, but over time, hair loss and visible skin damage may reveal the condition.
This disorder can significantly affect daily functioning and emotional well-being. In some cases, it may contribute to additional harmful behaviors, such as ingesting pulled hair.
Beyond the compulsive pulling, people with trichotillomania often report a sense of tension release or gratification after removing hair.
Behavioral therapy is the most effective treatment approach, particularly habit-reversal training. Certain medications, including antidepressants, may also offer relief. A stable and understanding support network is often critical to recovery.
Hair-pulling commonly affects areas such as the scalp, eyebrows, eyelashes, arms, torso, and legs.
Trichotillomania is a psychological disorder characterized by an uncontrollable urge to pull out one’s own hair, often from the scalp, eyebrows, eyelashes, or other body areas. This repeated behavior can lead to noticeable hair loss and emotional distress. If you find yourself asking, “Why do I keep pulling my hair out strand by strand?”—this condition could be the underlying reason.
The name "trichotillomania" comes from Greek, combining the words for hair, pulling, and mania. It was first introduced in medical literature by French dermatologist François Henri Hallopeau in 1889, though records of the behavior go back much further.
Notably, the philosopher Aristotle is believed to have described hair-pulling behavior as early as the 4th century BC, as highlighted in a 2018 article by Rachel LV Waas and Paul Devakar Yesudian in the International Journal of Trichology.
According to an article titled “Trichotillomania: What Do We Know So Far?” published by Melo and Lima in Trends in Psychiatry and Psychotherapy, trichotillomania is classified as a body-focused repetitive behavior and is increasingly recognized as part of the obsessive-compulsive spectrum. The review emphasizes that while the precise causes remain unclear, neurobiological factors, emotional regulation issues, and cognitive control impairments are strongly associated with the condition.
Yes, trichotillomania is classified under “Obsessive-Compulsive and Related Disorders” in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). While it was previously categorized as an impulse-control disorder, research and clinical understanding have since evolved to recognize its shared features with obsessive-compulsive disorder (OCD), such as repetitive, hard-to-control behaviors.
According to an article titled, “Comparisons Between Obsessive–Compulsive Disorder and Trichotillomania in Terms of Autistic Traits and Repetitive Behaviors in Adolescents” by Merve Onat and Ayda Beril Nas Ünver, published in the Nordic Journal of Psychiatry in November 2024, both OCD and trichotillomania present with elevated levels of repetitive behaviors and autistic traits when compared to control groups. These similarities support the inclusion of trichotillomania within the obsessive-compulsive spectrum, particularly in how both conditions involve impaired cognitive control and heightened compulsivity.
Despite this classification, key differences remain. For instance, individuals with trichotillomania may not always experience intrusive thoughts or obsessions prior to pulling hair, which is a hallmark characteristic of OCD. Instead, the behavior may be automatic or emotionally soothing rather than a response to obsessive fears.
This classification helps guide more effective treatment approaches, such as cognitive behavioral therapy and habit reversal training, which are commonly used in both OCD and trichotillomania cases.
Yes, trichotillomania is recognized as a mental illness. It is officially classified under “Obsessive-Compulsive and Related Disorders” in the DSM-5 due to its compulsive and repetitive nature.
According to an article titled “Hair-Pulling Disorder (Trichotillomania)” by Torales and Díaz in the International Journal of Social Psychiatry, this condition is a chronic psychiatric disorder often associated with anxiety and depression. The research emphasizes that early diagnosis and treatment are essential to prevent long-term emotional and physical consequences.
Individuals with trichotillomania experience recurring urges to pull out hair, leading to distress, impaired functioning, and reduced quality of life.
No, trichotillomania is not classified as an anxiety disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), it is categorized under “Obsessive-Compulsive and Related Disorders” due to its compulsive and repetitive nature.
However, trichotillomania frequently co-occurs with anxiety disorders. A case-control study by Parikh and Musolff found that individuals with trichotillomania often exhibit higher levels of anxiety compared to control groups. This suggests a significant overlap in symptoms and potential shared underlying mechanisms between trichotillomania and anxiety disorders.
While trichotillomania is distinct from anxiety disorders, its strong association with anxiety symptoms underscores the importance of comprehensive assessment and treatment approaches that address both conditions.
The exact cause of trichotillomania is not fully understood. Experts believe it arises from a combination of genetic, neurological, and environmental factors. Many individuals describe the behavior as relieving or pleasurable, which may reinforce the habit over time.
The disorder typically begins during late childhood or early adolescence and is commonly associated with other mental health conditions such as obsessive-compulsive disorder, anxiety, depression, autism spectrum disorder, and attention-deficit hyperactivity disorder. However, not everyone with these conditions develops trichotillomania, suggesting that additional risk factors are involved.
According to research, abnormalities in brain regions responsible for emotional regulation and impulse control may contribute to the behavior. Environmental stress, trauma, and difficulties with emotional processing can also act as triggers or exacerbating factors.
Trichotillomania is significantly more common in females than in males, particularly in clinical settings. While both genders can develop the disorder, women are more likely to seek treatment or be formally diagnosed, which may contribute to the observed gender differences.
Trichotillomania is defined by a pattern of body-focused repetitive behavior, most notably the compulsive act of pulling out one’s own hair. Several core traits help identify the disorder:
People with trichotillomania often feel a strong compulsion to pull their hair, followed by a sense of relief or gratification afterward. It is important to recognize that not every instance of hair pulling meets the criteria for this diagnosis.
Some individuals engage in hair-pulling intentionally to cope with stress or emotional discomfort. This is known as focused pulling. Others may pull their hair without being aware of it, such as while reading, watching television, or feeling bored. This is referred to as automatic pulling. A single person can experience both types, depending on their mental state or situation.
In many cases, hair-pulling rituals, preferences for certain textures or strands, and a narrowed focus on specific areas of the body are also present.
The signs and symptoms of trichotillomania include both visible hair loss and internal behavioral patterns. This disorder often begins in adolescence and may persist for years if untreated. Common symptoms include:
A 2022 study titled “Prevalence, Gender Correlates, and Comorbidity of Trichotillomania” by Grant and Dougherty found that the disorder frequently coexists with anxiety, depression, and obsessive-compulsive disorder. The condition is more commonly diagnosed in women, although underreporting among men may influence prevalence data.
Another study, “Clinical Characteristics of Trichotillomania” by Grant and Collins, highlights the dual nature of the disorder, both focused and automatic hair pulling are common. Mood states, sensory preferences, and environmental factors all contribute to how and when symptoms appear.
These patterns reinforce the need for early diagnosis, a supportive treatment environment, and integrated therapy approaches to reduce symptoms and restore emotional functioning.
The ways to manage trichotillomania involve practical techniques and supportive approaches that help individuals reduce hair-pulling urges and improve daily functioning. The most effective methods to manage trichotillomania are listed below.
There are several additional practices that may help individuals with trichotillomania reduce symptoms and feel more in control of their behavior. These include:
Yes, you can potentially qualify for disability benefits for trichotillomania — but only if the condition is severe enough to significantly impair your ability to function in daily life, maintain employment, or care for yourself independently.
Trichotillomania is recognized as a mental health disorder under the DSM-5 and may be considered for disability if it results in marked and documented limitations in key areas such as:
Eligibility for disability benefits (such as through Social Security Disability Insurance in the U.S.) typically requires comprehensive medical evidence. This may include psychiatric evaluations, treatment history, and statements from healthcare providers detailing the extent to which the disorder interferes with your functioning.
However, because trichotillomania alone is not explicitly listed as a qualifying condition, approval often depends on the presence of co-occurring disorders (like OCD, anxiety, or depression) and how the combination of symptoms affects your daily life.
Risk factors for trichotillomania refer to characteristics or conditions that may raise the chance of developing the disorder. The primary risk factors for trichotillomania are listed below.
Treatment for trichotillomania typically involves a combination of therapeutic interventions and medications. Several forms of behavioral therapy are used to help individuals manage and reduce hair-pulling behaviors. Common approaches include habit reversal training, acceptance and commitment therapy, and cognitive behavioral therapy.
Habit reversal training is considered the primary therapeutic method for trichotillomania. This treatment teaches individuals to recognize triggers that lead to hair pulling and to replace that behavior with more constructive alternatives. For example, instead of pulling hair, a person may learn to clench their fists or engage in another repetitive but harmless activity.
A case study published in 2012 in the International Journal of Trichology described a 22-year-old woman who achieved full remission from trichotillomania through habit-reversal training. The therapy appeared to help by reducing emotional distress and easing the self-criticism that often accompanies psychiatric symptoms.
Supporting this finding, a 2020 study by Heinicke et al. in the Journal of Applied Behavior Analysis confirmed that habit-reversal training is effective in reducing harmful behaviors. One key strength of this method is its emphasis on the role of a supportive environment in maintaining progress.
Other types of therapy are also beneficial for individuals with hair-pulling disorder.
Acceptance and commitment therapy teaches individuals to acknowledge the urge to pull hair without acting on it. This helps build resilience and fosters emotional flexibility.
Cognitive behavioral therapy focuses on identifying and replacing negative or distorted thoughts that contribute to hair-pulling. Through this therapy, individuals also develop healthier coping strategies for managing various emotional triggers.
In some cases, additional therapy may be recommended to address coexisting mental health conditions such as anxiety, depression, or substance use disorders.
There are currently no medications approved specifically for treating trichotillomania. However, physicians may prescribe medications to help manage symptoms or related mental health issues.
These can include antidepressants like clomipramine (Anafranil), mood-regulating supplements such as N-acetylcysteine, or atypical antipsychotics like olanzapine (Zyprexa) in certain cases.
In addition to clinically recommended treatments, some individuals explore alternative approaches such as hypnotherapy. A 2001 article in the American Journal of Clinical Hypnosis reported that guided imagery techniques may benefit adolescents with trichotillomania. However, it is important to note that alternative therapies should not replace standard medical care and should only be considered as complementary to professional treatment.
Trichotillomania, or hair-pulling disorder, does not currently have a definitive cure. However, evidence-based treatments can significantly reduce symptoms and improve quality of life.
Habit Reversal Training (HRT) is considered the first-line treatment. It involves increasing awareness of hair-pulling behaviors and replacing them with alternative actions.
Acceptance-Enhanced Behavior Therapy (AEBT) combines HRT with Acceptance and Commitment Therapy (ACT) techniques. A large randomized clinical trial demonstrated that AEBT led to greater reductions in hair-pulling severity compared to psychoeducation and supportive therapy.
Pharmacological treatments have shown mixed results. Some medications, like clomipramine and N-acetylcysteine, have been studied, but no medication has consistently proven effective for all individuals.
While trichotillomania may not be entirely curable, many individuals experience substantial improvement through tailored therapy and support.
Recovery from trichotillomania varies widely depending on the individual, the severity of symptoms, and the type of treatment used. There is no fixed timeline, but most individuals begin to see measurable improvement within 8 to 12 weeks of starting behavioral therapy, particularly habit reversal training or acceptance-based therapies.
In clinical studies, participants undergoing structured treatment programs have reported significant symptom reduction within 2 to 3 months, though full recovery or long-term remission may take 6 to 12 months or longer.
If left untreated, trichotillomania can become a chronic condition that persists for years. Consistent therapy, emotional support, and relapse prevention strategies are critical to achieving and maintaining long-term recovery.
According to a 2020 study by Grant and colleagues published in the American Journal of Psychiatry, the prevalence of trichotillomania ranges from 0.5 percent to 2.0 percent. Among adults, women are more commonly diagnosed than men, while in childhood the condition appears equally distributed between genders.
The same study examined data from 10,169 adults and found that 1.7 percent, or 175 individuals, were currently living with trichotillomania. The lifetime prevalence was recorded at 2.5 percent, which included 253 individuals who had experienced the condition at some point in their lives.
There were no significant gender differences in lifetime prevalence. The condition affected 1.8 percent of men and 1.7 percent of women. However, higher prevalence was observed in people under the age of 50, with rates ranging from 2.2 percent to 2.6 percent.
Household income, education level, and racial or ethnic background were not found to significantly influence the likelihood of developing trichotillomania in this study.
Although overall lifetime rates were similar across genders, specific age groups revealed differences. Men in the 30 to 49 age range were more likely to experience the disorder, while women between 50 and 69 had higher rates than men in that age group. The average age at which symptoms first appeared was 17.7 years.
Among those currently affected, 24 percent, or 42 out of 175 individuals, were also diagnosed with skin-picking disorder. The most common comorbid conditions included anxiety at 53 percent, depression at 45 percent, obsessive-compulsive disorder at 29 percent, post-traumatic stress disorder at 29 percent, and attention-deficit hyperactivity disorder at 29 percent.
Trichotillomania is closely linked to emotional health because it often functions as a way for individuals to express or regulate both negative and positive emotions.
For many people, hair-pulling becomes a coping mechanism for managing emotional discomfort. Individuals may turn to this behavior to relieve anxiety, depression, tension, boredom, fatigue, frustration, or feelings of loneliness. In such cases, the act of pulling hair can temporarily reduce psychological distress.
In some instances, trichotillomania may also be rooted in past trauma. The behavior may serve as a subconscious way to process or release emotional pain, acting as an outlet for unresolved psychological experiences.
On the other hand, hair-pulling is not always triggered by negative emotions. Some individuals experience a sense of gratification or even pleasure during or after pulling hair. This reinforcement may lead them to repeat the behavior in search of the same emotional reward.
Although emotional regulation plays a significant role in many cases, it is not the only contributing factor. Research by Lochner and colleagues, published in the 2021 edition of Frontiers in Psychology, identified additional influences, such as habit formation, impaired cognitive control, and episodes of dissociation that can also drive the behavior.
Yes, several well-known individuals have spoken publicly about their experience with trichotillomania, helping to bring awareness to the condition. These include Olivia Munn, Sara Sampaio, and Samantha Faiers.
Olivia Munn, an actress known for her work in The Newsroom, X-Men, and The Predator, has openly discussed her struggle with compulsive eyelash pulling. In a 2014 Self magazine feature by Ann Oldenburg, Munn revealed that her symptoms began at age 26 and were strongly linked to underlying anxiety, which she attributed to a difficult and chaotic upbringing. She credits hypnotherapy as a helpful tool in her recovery process.
Sara Sampaio, a Portuguese model and former Victoria’s Secret Angel, shared her story on Instagram in 2018. As reported in Harper’s Bazaar by Temi Adebowale, she began pulling out her eyelashes at the age of 15 and later moved on to her eyebrows. The behavior intensified during stressful periods, leaving gaps in her brows that she now conceals with makeup.
Samantha Faiers, an English model and television personality, has revealed that she has battled trichotillomania for over two decades. According to a 2021 article by Kate Dennett in Mail Online, she frequently pulls out her eyelashes and finds it difficult to manage the behavior, even doing it in her sleep.
There have also been unverified claims regarding other celebrities. Online sources frequently mention Megan Fox, suggesting she has been hospitalized multiple times due to trichotillomania, but no reliable evidence confirms this. Similarly, Charlize Theron, Kate Beckinsale, Colin Farrell, and Justin Timberlake are sometimes listed as having the condition, though these reports remain unsubstantiated. It is worth noting that Charlize Theron portrayed a character with trichotillomania in the film Young Adult, which may have contributed to the speculation.
Yes, trichotillomania causes hair loss. The repetitive pulling of hair from areas such as the scalp, eyebrows, or eyelashes leads to noticeable thinning, patchiness, or bald spots. Over time, this behavior can damage hair follicles, resulting in inflammation and scarring. In chronic cases, this damage may become permanent, leading to irreversible hair loss.
Consistent hair pulling can traumatize hair follicles, potentially leading to permanent baldness. The extent of hair loss varies among individuals, but prolonged and aggressive pulling increases the risk of permanent damage.
Plucking hair can slow down its regrowth. Each time a hair is plucked, the follicle undergoes trauma, which can delay the hair's return to the growth phase. Repeated plucking may weaken the follicle, and over time, this can lead to reduced hair density or permanent loss in the affected area.
In summary, trichotillomania leads to hair loss, and persistent hair pulling can cause permanent baldness. Additionally, plucking hair may slow down regrowth and potentially result in permanent hair loss over time.
Yes, hair can grow back after pulling it out due to trichotillomania, provided the hair follicles have not been permanently damaged. In most cases, if the behavior stops early and the follicles remain intact, hair begins to regrow within weeks to months. However, prolonged or aggressive pulling may cause scarring, leading to irreversible hair loss in some areas.
A case report titled “Trichotillomania: A Case Report” by Kluglein and Lo highlighted a 24-year-old woman who achieved full remission from hair-pulling behavior through psychological reframing, support systems, and protective strategies. Following cessation, hair regrowth was observed, demonstrating that recovery is possible with the right approach.
Regrowth timelines vary:
Effective recovery involves stopping the pulling behavior, addressing underlying emotional triggers, and consulting with dermatologists or mental health professionals. Early treatment improves the chances of complete regrowth and prevents long-term damage.
Hair regrowth after trichotillomania can take anywhere from several months to a few years, depending on the severity and duration of the behavior. In some cases, it may take between two and four years for hair to fully return, especially if pulling has been persistent and aggressive.
Repeated hair-pulling may injure the hair follicles, which can slow down the regrowth process. If the behavior continues without treatment for an extended period, the follicles may become permanently damaged. As noted in a 2021 article by James Roland for Healthline, this can result in permanent hair loss in certain areas.
The timeline for regrowth is highly variable. When the follicle remains intact, normal hair growth may resume. Eyelashes and eyebrows typically follow a growth cycle lasting one to six months. Scalp hair grows approximately six inches each year and can remain in the active growth phase for up to eight years. However, individuals with trichotillomania may not follow these typical patterns due to repeated trauma to the follicles.
If a follicle is fully removed or significantly impaired, it may no longer be able to support hair growth in that location. Early intervention and reducing hair-pulling behaviors can improve the chances of regrowth and prevent long-term follicle damage.
Trichotillomania can lead to a range of complications that affect both physical and emotional well-being, as well as overall quality of life. Common complications include psychological distress, damage to skin and hair, digestive issues, and social or occupational difficulties.
Emotional challenges are among the most frequently reported complications. According to a 2022 article from the Mayo Clinic, many individuals with trichotillomania experience intense feelings of shame, embarrassment, and guilt related to their behavior. These emotions can contribute to low self-esteem, depression, anxiety, and in some cases, substance use as a coping mechanism.
Another serious concern is trichophagia, a condition in which individuals eat the hair they have pulled. This behavior can result in the formation of hairballs within the digestive tract. Over time, these hairballs can lead to serious medical issues such as intestinal blockages, which may require surgical intervention and can even become life-threatening.
The repeated trauma of pulling hair may also lead to skin and hair complications. These can include infections, scarring, and in some cases, irreversible hair loss if follicles are permanently damaged.
Social withdrawal is another common outcome. Individuals may isolate themselves to avoid questions or judgment from others. This behavior can interfere with relationships, prevent them from participating in social activities, and cause them to miss educational or professional opportunities. Many also report difficulties with intimacy due to insecurity about their appearance.
There is currently no proven way to completely prevent trichotillomania. However, early recognition and timely intervention can reduce the risk of complications and help improve overall quality of life. This is supported by information from the Cleveland Clinic, which emphasizes the importance of prompt treatment in managing the disorder effectively.
Since stress often plays a central role in triggering hair-pulling behaviors, learning to manage stress through healthy coping mechanisms may be beneficial. Techniques such as mindfulness, regular exercise, relaxation practices, and structured routines can support emotional regulation.
One of the challenges in addressing trichotillomania is that many individuals are hesitant to speak openly about their symptoms. A 2016 review by Gawłowska-Sawosz and colleagues in Psychiatria Polska highlights the need for greater public awareness. When the condition is recognized early, treatment is more likely to be successful, and serious complications may be avoided.
While there is no guaranteed way to prevent the onset of trichotillomania, early treatment at the first sign of symptoms, along with effective stress management, can help limit the disorder’s long-term impact and improve emotional and social functioning.
Trichotillomania can harm a person’s health both physically and emotionally. The most immediate physical consequence is hair loss, which can lead to bald patches, scalp irritation, and, in severe or chronic cases, permanent follicle damage resulting in irreversible hair loss. Repeated trauma to the skin may also cause infections, scarring, or inflammation.
In some individuals, the condition includes trichophagia, the ingestion of pulled hair. Over time, this can lead to the formation of hairballs in the digestive system (trichobezoars), which may cause serious gastrointestinal issues and may require surgical removal.
Psychologically, trichotillomania often leads to feelings of shame, guilt, and embarrassment, especially due to visible hair loss. This emotional burden can result in low self-esteem, anxiety, depression, and social withdrawal, all of which may interfere with work, relationships, and daily functioning.
Left untreated, the condition can become chronic, compounding both mental and physical health challenges over time. Early diagnosis and targeted treatment are critical to minimizing harm and restoring well-being.
No, trichotillomania does not cause cancer. There is no scientific evidence linking the act of pulling out hair to the development of cancer.
However, individuals with trichotillomania who ingest pulled hair (a condition known as trichophagia) may develop trichobezoars, hairballs that accumulate in the stomach or intestines. While these can lead to serious complications like digestive blockages or infections, they do not lead to cancer.
Yes. While trichotillomania is primarily a psychological disorder, it can lead to physical symptoms such as headaches. The repetitive action of pulling hair, especially from the scalp, may cause tension and strain in the surrounding muscles and tissues, potentially resulting in headaches. Additionally, the stress and anxiety associated with the urge to pull hair can contribute to the development of tension-type headaches.
It's important to address both the psychological and physical aspects of trichotillomania to alleviate symptoms and improve overall well-being.
Yes. While trichotillomania primarily involves compulsive hair-pulling behaviors, it can lead to nerve-related complications in certain cases.
Peripheral Nerve Damage: Repeated hair-pulling, especially from the scalp, eyebrows, or other areas, can cause trauma to the skin and underlying tissues. Over time, this may result in peripheral nerve irritation or damage, leading to sensations such as tingling, numbness, or pain in the affected regions.
Central Nervous System Changes: Neuroimaging studies have identified structural and functional brain differences in individuals with trichotillomania. For instance, research has shown reduced integrity of white matter tracts connecting regions like the orbitofrontal cortex and anterior cingulate cortex, areas involved in habit formation and impulse control. These alterations suggest that trichotillomania may be associated with changes in neural circuits related to motor control and behavioral regulation.
While direct nerve damage from hair-pulling is not common, the combination of physical trauma and underlying neurological factors underscores the importance of early intervention. Addressing trichotillomania through therapeutic approaches can help mitigate potential complications and improve overall well-being.
Kleptomania is the recurrent failure to control a consistent impulse to steal unneeded items. It is a rare yet serious mental health disorder that can cause serious repercussions on one’s life if left untreated.
Pyromania is an uncommon impulse control disorder marked by an inability to resist the urge to deliberately start fires. The earliest signs may appear during childhood, and in some cases, symptoms have been observed in children as young as three.
Trichotillomania is a mental health condition marked by an ongoing urge to pull out one’s hair, even when the individual tries to resist the behavior.
Impulse control disorder refers to a group of mental health conditions in which individuals struggle to resist impulses to perform certain behaviors, even when these actions have negative consequences.
Mental health disorders are medical conditions that affect how a person thinks, feels, behaves, and interacts with others.
