This book describes Hair Pulling Disorder, Diagnosis and Treatment and Related Diseases
Hair pulling disorder, also known as trichotillomania, is a mental health disorder typified by an irresistible urge to pull out one's hair, resulting in noticeable hair loss.
Studies show that 0.5 to 2 % of people have hair-pulling disorder.
Many children who develop hair-pulling disorder will direct the pulling out of the hair from their head, often directed on 1 or 2 regions of the scalp.
People with hair-pulling disorder do not always restrict hair pulling to the scalp.
They may also pull hair from other parts of the body such as the eyebrows, eyelashes, pubic hair or any other region on their body that has hair.
Over a period this person will have bald spots and thinning hair.
Hair pulling disorder or Trichotillomania normally starts during the adolescent years but it has been known to appear in young children, too.
Based on a 2016 study, the characteristic age for the symptoms to appear is 10-13 years old.
Once it begins, it can carry on for several years through to adulthood.
The precise cause of hair pulling disorder is not known.
It is regarded as a complex medical disorder that may result from a combination of genetic, neurobiological and psychological factors.
Some possible causes are:
Genetic predisposition:
Hair pulling disorder is likely to run in families, indicating a genetic component.
Neurobiological factors:
Certain imbalances in neurotransmitters (chemical messengers in the brain) such as serotonin and dopamine which are involved in mood regulation and impulse control may cause the development of the hair pulling disorder.
Emotional regulation difficulties:
Hair pulling can be a method to cope with stress, anxiety or other negative emotions.
Behavioral conditioning:
Persons with hair pulling disorder may feel a sense of relief or pleasure after pulling out their hair, reinforcing the behavior.
Emotional factors may also play a part.
The patient normally begins by pulling out the hairs on the scalp first, an action that makes the person feel relief with less anxiety or stress.
Many people do not even know that they are pulling out their own hair.
The realization that they are pulling out hair can cause more feelings of anxiety and embarrassment.
This produces a cycle of anxiety, hair pulling, temporary relief and then anxiety, embarrassment, and hair pulling again.
The primary symptom of hair pulling disorder is the recurrent and compulsive pulling out of hair, normally from the scalp but can also involve eyebrows, eyelashes, or other body areas.
Symptoms of Hair pulling disorder are:
Pulling out hair repeatedly
Breaking off pieces of hair
Eating hair (trichophagy)
Feeling relieved after pulling hair out
The progression of symptoms is:
An increasing sense of tension or anxiety before pulling out the hair.
A feeling of relief or pleasure after pulling out the hair.
Noticeable hair loss, which may lead to bald patches or thinning hair.
Persistent efforts to stop or reduce hair pulling, often unsuccessful.
Significant anguish or harm in social, occupational, or other important areas of functioning.
A diagnosis of hair pulling disorder is normally made by a mental health doctor based on the medical history and a comprehensive examination
Hair pulling disorder can be difficult to treat but several methods are effective.
Cognitive-behavioral therapy
Medicines - N-acetylcysteine, Olanzapine