What is Trichotillomania? Compulsive Hair Pulling.

What is Trichotillomania?
Trichotillomania (TTM or “trich”) is a disorder that results in compulsive hair pulling from any site on an individual’s body, ultimately causing bald patches. Hair pulling most commonly occurs from the scalp, eyelashes, and eyebrows, but can also occur in such sites as the arms, legs, underarms, and pubic regions. As with most other disorders, hair pulling can vary greatly in terms of its onset, severity, and response to treatment. Without treatment, however, trichotillomania tends to be a chronic condition that waxes and wanes throughout an individual’s lifetime.
 
What Causes Trichotillomania?
Unfortunately, a clear or distinct cause of this disorder has not yet been identified. However, recent research does point to genetics playing some role. Thus, it stands to reason that you are more likely to develop trich should another family member struggle with the disorder. Most likely, TTM is similar to other disorders in the sense that a combination of genetic, environmental, and presence of co-morbid disorders ultimately leads to the development of the disorder.
 
Who Gets Trichotillomania?
Trich is definitely more common than you likely think, though you wouldn’t know it as those afflicted by the disorder experience significant shame and thus often look to do all in their power to hide it. Recent research shows that approximately 2 in every 50 individuals suffer from trich at some point in their lifetime! TTM does not discriminate as it impacts individuals of all ages, races, and walks of life. It usually begins in late childhood/early puberty and tends to occur equally in boys and girls during childhood. However, roughtly 80-90% of reported cases in adults are women (this may be at least partially due to the fact that women are more likely to seek help than men).
 
How Do You Treat Trichotillomania?
No single treatment has been found to be universally effective for trichotillomania, but there are a number of available treatment options that have helped numerous individuals. Given the complex and variable nature of trich, it is indeed difficult to come up with a “one size fits all” treatment approach. Instead, treatment options should be viewed as an array of available tools with the goal being to find the tools that work for you and stockpiling a few successful ones in your toolbox for use to combat your trich.
 
These treatment options can include therapy (ie, behavioral therapy or cognitive behavioral therapy), medications (usually antidepressants though other options exist), hypnosis, biofeedback, and engagement in support groups.
 
The bottom line is that there is indeed hope should you or a loved one be suffering from trich!
 
I hope that this brief introduction to trichotillomania was useful, and please don’t hesitate to reach out to CPCH with any other questions or concerns that you may have.
 
For a wealth of TTM resources, be sure to check out trich.org.
 
Live Mentally Health,
Dr. Matt Bader
Trichotillomania Specialist
Author
Dr. Matt Bader Specializing in addiction psychiatry in adults, Matt Bader, MD, is a board-certified psychiatrist providing care at Cognitive Psychiatry of Chapel Hill in Chapel Hill, North Carolina. The New Jersey native has made the Tar Heel State his permanent home. After completing his undergraduate degree at Rutgers University in New Brunswick, New Jersey, Dr. Bader went on to earn his doctor of medicine degree from Robert Wood Johnson Medical School in New Brunswick, New Jersey. Dr. Bader completed his psychiatry residency at Duke University Medical Center in Durham, North Carolina. He received subspecialty training in addiction psychiatry as a fellow at the Medical University of South Carolina in Charleston. Taking a holistic approach to addiction psychiatry, Dr. Bader works to treat mood-related conditions, like anxiety and depression in addition to addiction issues. This approach allows Dr. Brader to treat the whole person and not just the addiction. Dr. Bader strives to provide each patient with the comprehensive

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