Trichotillomania - Symptoms, causes and treatment

Trichotillomania is a mental disorder what makes The sufferer has an irresistible urge to pull out his hair on the headhis. People with trichotillomania also have a desire to pluck hair on other parts of the body, such as eyebrows and eyelashes.

Generally, people with trichotillomania have the urge to pull out their hair when experiencing stress or anxiety. Patients believe that pulling their hair can relieve stress or anxiety they experience. This habit is very difficult to break, even though the sufferer knows it is not good for him.

Trichotillomania can cause uneven hair baldness. As a result, sufferers will be embarrassed and try to cover it up by avoiding other people. Sufferers will also feel depressed because they feel they have bad and strange habits.

With prompt and appropriate treatment, trichotillomania can be reduced or stopped. Otherwise, this condition has the potential to cause mental disorders or skin damage.

Reason and Risk Factors Trichotillomania

The exact cause of trichotillomania is not known with certainty. Some experts argue that this condition is related to environmental and hereditary factors. In addition, there are several factors that can increase a person's risk of experiencing trichotillomania, namely:

  • 10–13 years old
  • Have a family history of trichotillomania or other mental disorders
  • Have another mental disorder, such as obsessive compulsive disorder (OCD), anxiety disorder, or depression
  • Experiencing a stressful or stressful situation or event
  • Having other bad habits, such as thumb sucking or nail biting
  • Suffering from a disease caused by a nervous system disorder, such as Parkinson's disease or dementia
  • Having abnormalities in the structure and metabolism of the brain

GTrichotillomania symptoms

The following are symptoms and signs that appear in people with trichotillomania:

  • Pulling hair repeatedly, either on the head, eyebrows, or other areas of the body
  • Feeling anxious before pulling hair or when refraining from doing it
  • Feeling satisfied and relieved after pulling hair
  • Having a certain kind of habit that is always done before pulling hair, for example choosing the hair to be pulled out
  • Never managed to resist the urge to pull out hair
  • Playing or rubbing hair that has been pulled out on certain areas of the body, such as the face or lips
  • Experiencing disturbances and difficulties in the social sphere

In some cases, people with trichotillomania can also have other disorders, such as the habit of picking at the skin, biting fingernails (onycophagia), or biting his lip. People with trichotillomania may also have a habit of plucking animal hair, doll hair, or thread from clothes.

Symptoms of trichotillomania can appear when the sufferer feels tense or stressed. However, sometimes symptoms can also appear without realizing it.

When to go to the doctor

Check with your doctor if you're constantly pulling your hair out, especially if you've been trying to stop yourself from doing it again.

Immediately see a doctor if you have a habit of eating hair that has been pulled out (Rapunzel syndrome). This should not be allowed, because eaten hairballs can clog the intestines.

Diagnosis of Trichotillomania

To diagnose trichotillomania, the doctor will ask questions about the patient's symptoms, as well as the patient's and family's medical history. Next, the doctor will examine the part of the patient's body that is often pulled hair and how much the patient loses hair.

Doctors can confirm the diagnosis of trichotillomania in patients who have the following criteria:

  • The habit of pulling hair continuously, to experience hair loss
  • Difficulty in stopping and refraining from pulling hair
  • The habit of pulling hair to the point of causing disturbances and difficulties in social life
  • The habit of pulling hair is not caused by diseases of the hair or skin
  • The habit of pulling hair is not caused by another mental disorder, the symptom of which is the act of pulling hair

If needed, the doctor may perform a biopsy (tissue sampling) to identify other causes of hair loss, such as a scalp infection.

Trichotillomania Treatment

The goal of treatment for trichotillomania is to reduce or stop the sufferer from pulling hair. Some of the treatment methods that can be done are:


Psychotherapy to treat trichotillomania is done in the form of psychological therapy with a psychiatrist. This method will focus on changing the patient's behavior by diverting the act of pulling hair into an activity that does not have a bad impact.

The patient will be asked to observe and identify when and where the urge to pull the hair occurs. After that, the patient will be directed to be able to calm down when the urge appears and replace it with other activities so that the urge to pull hair is diverted and disappears.

Some of the ways that people with trichotillomania usually divert urges include:

  • squeezing stress ball or something similar
  • Playing tools that can distract from anxiety, such as fidget cube
  • Saying or shouting a sentence or word repeatedly, for example counting 1, 2, 3, and so on
  • Take a bath or soak in a relaxing atmosphere to relieve feelings of restlessness or anxiety that arise
  • Learn breathing techniques to calm and relieve symptoms when they flare up
  • Exercise regularly
  • Cut hair short


In addition to therapy, doctors can also give antidepressant drugs class serotonin reuptake inhibitor (SSRI) for symptomatic relief of trichotillomania. These drugs can be used alone or in combination with antipsychotic drugs, such as olanzapine and aripiprazole.

It is important to remember that the dose of SSRI drugs in each patient with trichotillomania depends on the age and severity of the condition. Therefore, the use of this drug must be in accordance with a doctor's prescription.

Trichotillomani complicationsa

Patients with trichotillomania who do not undergo proper therapy can experience complications such as:

  • Disturbances in social life, due to shame or lack of self-confidence
  • Skin damage due to hair pulling, in the form of scars or permanent baldness
  • Other mental disorders, such as depression

In trichotillomania patients who also have Rapunzel syndrome, another complication that can occur is impaired digestive tract function. This condition can cause weight loss and blockage in the intestines.

Trichotillomania Prevention

There has been no proven effort to prevent trichotillomania. However, understanding how to manage stress can help lower your risk of developing trichotillomania. Here are some ways to manage stress:

  • Get used to seeing things from the positive side
  • Learn to understand that some things can't be controlled
  • Don't harbor feelings or opinions
  • Learn relaxation methods, such as yoga
  • Exercise regularly
  • Eat a healthy and balanced diet
  • Learn discipline and have good time management
  • Dare to refuse requests that can trigger stress (be assertive)
  • Providing free time to do interesting hobbies or activities
  • Provide sufficient time to sleep and rest
  • Don't rely on alcohol or drugs to relieve stress
  • Seek social support and spend time with someone you feel comfortable with