Trichotillomania: The Urge to Pull Hair

Many people absentmindedly twirl or tug their hair when stressed, but for those with trichotillomania, hair-pulling becomes a compulsive, repetitive behavior that’s hard to control. Trichotillomania is a mental health condition that falls under the category of body-focused repetitive behaviors (BFRBs) and is closely related to obsessive-compulsive spectrum disorders.

What Is Trichotillomania?

Trichotillomania involves recurrent, irresistible urges to pull out hair from the scalp, eyebrows, eyelashes, or other parts of the body. Despite attempts to stop, the behavior persists, often leading to noticeable hair loss and emotional distress.

Signs and Symptoms

• Repeated pulling of hair, often during times of stress or boredom

• A sense of tension before pulling, followed by relief afterward

• Bald spots or thinning hair from repeated pulling

• Avoidance of social situations due to embarrassment

• Use of hats, scarves, or makeup to conceal hair loss

Some individuals also engage in related behaviors, such as chewing or playing with the pulled hair.

Emotional Impact

Trichotillomania can take a significant toll on self-esteem and quality of life. People often feel ashamed, guilty, or frustrated by their inability to stop. This shame may lead to secrecy, making it harder to seek help. Social withdrawal is common, as individuals worry about how others will perceive them.

Why Trichotillomania Happens

The exact cause of trichotillomania is unknown, but it is believed to involve a combination of genetic, neurological, and environmental factors. Stress, anxiety, and perfectionism can act as triggers, and the hair-pulling itself may serve as a coping mechanism for managing uncomfortable feelings.

Treatment Options

Several therapeutic approaches can help individuals reduce or stop hair-pulling:

• Habit Reversal Training (HRT): A behavioral therapy that teaches awareness of pulling urges and introduces competing responses.

• Cognitive-Behavioral Therapy (CBT): Helps address underlying thoughts and emotions that trigger pulling episodes.

• Acceptance and Commitment Therapy (ACT): Encourages acceptance of urges without acting on them, while focusing on values-based living.

• Medication: In some cases, medication may be prescribed to help with co-occurring conditions such as anxiety or depression.

Living with Trichotillomania

While it can feel overwhelming, many people with trichotillomania experience improvement with treatment. Support groups and therapy provide understanding, reduce shame, and offer tools for managing urges. Over time, individuals can learn healthier coping strategies and regain confidence.

Breaking the Silence

Trichotillomania is more common than many realize, yet it often goes undiscussed due to stigma. By bringing awareness to this condition, we can reduce shame and encourage those affected to seek support.

Recovery is not about perfection, it’s about progress, learning to manage urges, and living life more fully without being defined by the behavior.

If this resonates with you, we’d love to work with you for OCD therapy. We offer a free 20-minute phone consultation to discuss your concerns and how our therapy services can support your journey.

Schedule your free consultation or your first full appointment by contacting us via phone or email at support@elevationbehavioraltherapy.com or (720) 295-6566 (call or text). Or, you can book here directly on our website.

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