It is common for us to play with our hair. We run our fingers through it or twirl it as we’re working, watching TV, concentrating and even when we’re stressed and worried. This habit is harmless however for some, it can lead to a self-inflicted hair loss condition called trichotillomania. This is where twirling your hair turns into pulling your hair.

When someone with trichotillomania pulls their hair continuously out of habit or nerves, this can cause bald patches or thinness throughout the scalp. Hair can grow back at first, but eventually the follicles become damage and the pulling leads to permanent hair loss.

Trichotillomania can be emotionally distressing and an upsetting condition and it is best to treat it before permanent damage is caused.

Trichotillomania is more common in women than in men and it mainly occurs during puberty and menopause. While the causes are often complex the habit may be related to anxiety where pulling of the hair is a means of coping with stress, depression or a traumatic experience. The feeling of pulling out a hair can feel satisfying to someone with this disorder and they keep doing it without realizing the damage they are causing. Once it becomes a habit it is difficult to stop the behavior.

Because it presents as hair loss, trichotillomania can get misdiagnosed as alopecia areata, a hair loss condition that occurs in patches. These conditions resemble each other in appearance and often the patient suffering from trichotillomania is ashamed or embarrassed to admit to their doctor that the hair loss is self-inflicted. A telling sign of trichotillomania is uneven hair breakage because when a hair is pulled out it can’t be pulled out at the same angle every time so it snaps off at different lengths. In addition, if the patient is right handed, hair loss may be more noticeable on the right side of the scalp and vice versa.

Recovery from trichotillomania often requires help. Psychotherapy may be needed and it is nothing to be ashamed of. Just as in recovery from any other condition, external support is sometimes useful and necessary.

Wearing thick gloves can help when the urge to pull hair arises. Cutting hair short so it’s impossible to grab hold of is also an effective treatment. Applying a slippery cream or oil will make it difficult to pull the hair as will wearing. A form of distraction may also be effective such as playing with worry beads to take the mind away from the impulse to pull.

Treatment and recovery from trichotillomania takes time and patience but luckily the hair will grow back. If the behavior has been going on for a long time less will grow back or it may grow back a different texture but there will be a noticeable improvement.

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