Trichotillomania (Hair-Pulling Disorder)

Trichotillomania (often abbreviated as TTM) is a mental health disorder where a person compulsively pulls out or breaks their own hair. This condition falls under the classification of obsessive-compulsive disorder (OCD). When it’s severe, it often has extremely negative effects on a person’s happiness, well-being and overall quality of life.

Trichotillomania (pronounced trick-oh-till-oh-main-ee-uh) comes from three Greek words:

• Tricho: hair.
• Tillo: pull.
• Mania: excessive behavior or activity.

What is the difference between trichotillomania and obsessive-compulsive disorder?

TTM falls under the overall category of obsessive-compulsive disorder, but it has some key differences from OCD itself.

• Obsessions. OCD involves obsessions, which are thoughts or urges that a person can’t control and doesn’t want. TTM doesn’t involve obsessions.
• Feeling of reward. When people with TTM pull out their hair, they often feel relief or other positive emotions. OCD doesn’t involve positive feelings in that way.

Who does it affect?

TTM is especially common in children and adolescents. In young children and infants, it’s usually a short-lived concern and goes away on its own. The more serious form most commonly starts between ages 10 and 13.

In children, it happens equally between men and women. In adults, women outnumber men with this condition by as much as 9 to 1.

How common is this condition?

TTM is relatively uncommon. Research studies estimate it affects 0.5% to 3.4% of adults at some point in their lifetime.

How does this condition affect my body?

People with TTM compulsively pull out their hair, usually one strand at a time. Many people will pull hair from the same spot. The most common places people pull hair from are their scalp, eyelashes and eyebrows, and pubic hair.

The effects of trichotillomania also depend on the age at which it happens. Children commonly pull their hair in this way, but that behavior is often a self-soothing act. Children often grow out of this behavior and don’t have any long-term negative effects. Adolescents, teenagers and adults with this condition tend to have much more severe problems.

Mental health effects

People with TTM commonly feel anxiety, embarrassment or shame about this condition. This can affect their work and social lives. Many people with this condition don’t seek treatment because they feel embarrassed or ashamed.

Trichophagia

About 20% of people with this condition eat their hair after pulling it, a condition known as trichophagia (from Greek words “tricho” for hair and “phagia” for eating). This can lead to hairball-like blockages in their digestive tract. Those blockages are sometimes dangerous and often cause damage that needs surgery to repair.

People with TTM commonly hold back from telling their healthcare provider about this even after revealing details about TTM. This is often because they’re waiting until they feel they can trust their provider more before sharing that amount of detail.

Hair, skin and tissue damage

People who pull out their hair often cause damage to their skin and tissue just underneath the skin’s surface, especially if they use any kind of personal care tool like tweezers. Skin and tissue damage sometimes need repair or skin grafting to fix. Damage to skin caused by hair pulling can also cause permanent hair loss in affected areas.