http://youtube.com/watch?v=EY0ji6t51mo 1:41
Understanding Trichotillomania (Hair Pulling Disorder)
If your child or teen repeatedly pulls out their hair, struggles to stop despite wanting to, or experiences embarrassment related to hair loss, specialized trichotillomania treatment can help.
Anxiety Institute provides evidence-based panic disorder assessment and treatment for teens and young adults in Greenwich, CT; Madison, NJ; and McLean, VA, with online options available. Families searching for a panic disorder therapist or panic disorder treatment center can access specialized care from our experienced clinicians using proven approaches, including cognitive behavioral therapy (CBT) and exposure and response prevention (ERP). Early treatment can reduce panic symptoms, decrease avoidance, and help young people regain confidence and independence. Contact us for a complimentary consultation to learn which program may be the best fit for your family.
Signs and Symptoms
Trichotillomania, also known as hair pulling disorder, is characterized by recurrent urges to pull out hair from the scalp, eyebrows, eyelashes, or other areas of the body.
Many individuals report feeling unable to resist the urge despite repeated attempts to stop.
Common Emotional and Cognitive Symptoms
- Strong urges to pull hair
- Difficulty resisting pulling behaviors
- Feelings of tension before pulling
- Relief or gratification after pulling
- Shame or embarrassment about the behavior
- Frustration over unsuccessful attempts to stop
- Worry about others noticing hair loss
Common Behavioral Symptoms
- Pulling hair from the scalp, eyebrows, eyelashes, or body
- Pulling during periods of stress, boredom, or relaxation
- Playing with pulled hairs
- Examining hair roots or texture
- Avoiding situations where hair loss may be noticed
- Wearing hats, wigs, or makeup to conceal hair loss
- Seeking privacy to engage in pulling behaviors
Common Physical Symptoms
- Noticeable hair loss
- Bald patches
- Thinning hair
- Missing eyelashes or eyebrows
- Skin irritation in affected areas
Early Trichotillomania Assessment Matters
A comprehensive trichotillomania assessment can help determine whether symptoms are related to hair pulling disorder, OCD, anxiety, perfectionism, or another concern.
Our assessments evaluate:
- Pulling frequency and severity
- Triggers and emotional patterns
- Awareness of pulling behaviors
- Impact on school, social functioning, and self-esteem
- Co-occurring anxiety, OCD, depression, or related concerns
- Recommended level of care
Early identification often leads to better treatment outcomes and reduced impairment.
Impact on School, Family, and Relationships
School Impact
Students with trichotillomania may:
- Avoid participating in class
- Experience difficulty concentrating
- Feel distracted by urges
- Miss activities due to embarrassment
- Struggle with self-confidence
Social Impact
Hair pulling disorder can affect:
- Friendships
- Dating and relationships
- Participation in activities
- Self-esteem and body image
- Willingness to be photographed or attend social events
Many adolescents work hard to hide symptoms and fear others will notice hair loss.
Family Impact
Families often experience:
- Concern about worsening symptoms
- Frustration when attempts to stop are unsuccessful
- Uncertainty about how to help
- Increased stress related to appearance concerns
Trichotillomania Treatment
Evidence-Based Trichotillomania Treatment: CBT and Habit Reversal Training
The gold standard treatment for trichotillomania is cognitive behavioral therapy (CBT) incorporating habit reversal training (HRT).
Habit reversal training helps individuals:
- Increase awareness of pulling behaviors
- Identify triggers and high-risk situations
- Develop competing responses
- Build alternative coping strategies
- Reduce automatic pulling patterns
Treating Body-Focused Repetitive Behaviors (BFRBs)
Trichotillomania is one type of body-focused repetitive behavior (BFRB). Treatment often focuses on understanding the function of the behavior while developing healthier ways to manage emotions, stress, boredom, and sensory experiences.
Parent and Family Support
For children and adolescents, treatment often includes parent involvement to help families:
- Reduce shame and criticism
- Support treatment goals
- Reinforce healthy coping skills
- Create supportive home environments
Medication Support
For some individuals, medication may be recommended as part of a comprehensive treatment plan, particularly when anxiety, OCD, or depression are also present.
Trichotillomania Treatment Center in CT, NJ, and VA
Anxiety Institute specializes in treating anxiety disorders, OCD-related conditions, and body-focused repetitive behaviors in adolescents and young adults.
We offer:
- Comprehensive trichotillomania assessments
- Individualized treatment plans
- Cognitive Behavioral Therapy (CBT)
- Habit Reversal Training (HRT)
- Parent guidance and family support
- Intensive outpatient treatment options
- In-person treatment in Connecticut, New Jersey, and Virginia
- Online treatment in eligible locations
Help for Hair Pulling Disorder
Trichotillomania is a treatable condition, and many adolescents experience significant improvement with specialized care. If hair pulling is affecting your child’s confidence, relationships, school functioning, or daily life, contact us today for a complimentary consultation.
Our team will answer your questions, explain treatment options, and help determine the right next step for your family.
Resources
Behavior therapy for pediatric trichotillomania: Exploring the effects of age on treatment outcome
Child and Adolescent Psychiatry and Mental Health
Read Article
Duke, C. D., Keeley, L. M., Geffken, R. G., Storch, A. E. (2010) Trichotillomania: A current review. Clinical Psychology Review, 30(2), 181-193.
Mental Health America;
http://www.mentalhealthamerica.net/conditions/trichotillomania-hair-pulling
Recent Advances in the Understanding and Treatment of Trichotillomania
J Cogn Psychother
Read Article
Stay Out of My Hair
Suzanne Mouton-Odum, Goldum Publishing. (2009).
Find it on Amazon
StopPulling.com;
http://ww2.stoppulling.com
The TLC Foundation for Body-Focused Repetitive Behaviors;
www.bfrb.org
Trichotillomania and Co-occurring anxiety
Comprehensive Psychiatry
Read Article
Trichotillomania & Hair Pulling: It’s More than Just Stress!
Ali M. Mattu, Ph.D.
Read Article
Quick FAQs
Compulsive Hair Pulling (Trichotillomania)
Scroll down for more detailed information and additional resources.
What is trichotillomania and how is it treated? 1:41
Trichotillomania, or TTM, is a mental health condition classified as a body-focused repetitive behavior (BFRB). It involves compulsively pulling out or breaking hair from the scalp, eyebrows, eyelashes, or other areas. Unlike OCD, TTM does not involve obsessions, and individuals often feel relief or positive emotions after hair pulling.
Symptoms include repeated hair pulling that causes noticeable hair loss, biting, chewing, or eating pulled hair, and repeated attempts to stop or reduce the behavior. The behavior often negatively affects daily life and must be distinguished from other medical conditions. TTM often appears in early adolescence, around 10 to 13 years old.
The causes of TTM are not fully understood but include genetic predisposition, differences in brain structure or chemistry affecting dopamine and serotonin regulation, and using hair pulling as a coping mechanism for stress or strong emotions.
Diagnosis is clinical. A healthcare provider reviews health history, current behaviors, and any underlying medical conditions. In some cases, a small skin sample may be analyzed, and additional tests like a CT scan or blood work are used if there are concerns about ingested hair causing blockages.
No. TTM is a chronic condition. Symptoms may fluctuate and go through periods of remission, but treatment is usually needed for consistent management. Hormonal changes, particularly in women, can temporarily worsen symptoms.
Effective treatments include habit reversal training (HRT) with treatment such as cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) to manage urges. Certain medications may be beneficial for some individuals, especially in combination with therapy.
Symptoms can increase during stress, anxiety, or boredom. Low levels of physical activity may also contribute. Co-occurring conditions such as anxiety, depression, OCD, or ADHD can intensify hair pulling behaviors.
TTM can cause emotional distress, shame, low self-esteem, and social withdrawal. It may create tension in family or peer relationships and interfere with school, work, or social activities. Ingesting hair can lead to digestive complications such as hairballs that may block the intestines.
Support includes listening without judgment, helping identify triggers and develop replacement behaviors, and encouraging professional treatment. Understanding and empathy are key to fostering recovery.