Trichotillomania is an impulse hair pulling disorder. A person with trichotillomania (trich for short) cannot control the urge to pull out their hair.

Trichotillomania derives its name from three Greek words:
Tricho – hair
Tillo – to pull
Mania – excessive or unreasonable enthusiasm
The most common areas people pull from are their scalp, eyelashes and eyebrows. Other areas people may pull from include their beard, chest, underarms, pubic area, and legs. Some use their hands, while others pull with tweezers.

Trich can start at any time during one’s lifetime, but most often presents during late childhood or early puberty. In childhood, the disorder is evenly split between both males and females; in adults, as many as 80-90% of those with the disorder are female.
It is estimated that 2-4% of the American population deals with this issue on a daily basis. There is no one reason for why or how the disorder starts. For some, it begins with a traumatic event; for others, it can start with something as simple as an itchy scalp. Researchers are now finding that for those who have certain genes are predisposed to the disorder.

People with trich are not trying to harm themselves. For many, the urge to pull out hair comes on when they are dealing with stress, anxiety, or depression. Other people are not even aware they’re doing it until after it’s done. Still others are not just aware they’re pulling, but create a ritual around it. For some, there is a great sense of relief after they have pulled. Many who pull report feeling a sense of calm and peace while pulling.

However, while people report feelings of relief, peace and calm while pulling, afterwards most feel upset and embarrassed. The disorder can leave people with bald patches, as well as missing eyelashes, eyebrows and even scars in some areas. While hair can grow back, there is also the possibility with prolonged hair pulling that it may not. Many people will go to great lengths to hide the hair loss by wearing hats, scarves, wigs, makeup – some even go as far as to get permanent eyeliner or eyebrows tattooed on themselves.

While treatment options exist, there is no one cure for trichotillomania. For some, simply keeping busy can curtail some of the hair pulling. However, many with the disorder do not respond to treatment and will deal with the disorder for the duration of their lifetime.
Treatment options include pharmaceutical medications and/or cognitive behavior therapy (CBT), a form of psychotherapy that treats problems by modifying dysfunctional emotions, behaviors, and thoughts. CBT can be tailored to fit individual patients, and focuses on solutions by encouraging patients to challenge and change certain patterns of behavior.