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How to Deal with Trichotillomania

Instructor: Artem Cheprasov
While we've all wanted to pull our hair out at one point or another, we probably only did so once and didn't really follow through on it. This isn't the case for all people, though. Read on to learn about how doctors and patients deal with trichotillomania.

Causes

Have you ever gotten so upset at something that you wanted to pull your hair out? Maybe you actually did a little bit. Maybe it was someone else's hair that you pulled out in anger. Hopefully not, though! That kind of hair pulling is one thing. It's transient and it usually doesn't cause any significant (if any) hair loss.

But some people actually do want to pull their hair out on a persistent and excessive basis, and irresistibly so. Find out what this disorder is called and how it may be dealt with.

What is Trichotillomania?

The disorder in question is technically called trichotillomania. More commonly it's just known as hair-pulling disorder. The former term is highly confusing but it actually defines this problem very well if we just break it down:

  • 'tricho-' means hair.
  • '-tillo-' refers to pulling out.
  • '-mania' refers to an obsessive preoccupation with something.

In other words, trichotillomania literally translates to as an obsessive preoccupation with pulling out (one's own) hair.

Now, this isn't just hair on the head we all may grasp in a fit of stress. This is pulling out hair on the head, eyebrows, eyelashes and other places to the point of partial or total baldness of these areas.

Treatments

Trichotillomania can be approached and dealt with in different ways (or a combination thereof). It all depends on whom it affects and how long it has been present for.

Unfortunately, there is no magical drug that stops this disorder and none of the drugs used for this disorder are consistently effective. In general, however, a group of medication called selective serotonin reuptake inhibitors, or SSRIs, may help some people with trichotillomania somewhat.

An example of such a medication is called fluoxetine. Drugs like fluoxetine work by increasing the levels of a neurotransmitter called serotonin in the brain. Other medications that have been tried for this disorder, with mixed success or a lack of strong evidence for success, include:

  • n-acetylcysteine (derived from an amino acid)
  • dronabinol (a cannabinoid)
  • olanzapine (an atypical antipsychotic)
  • clomipramine (a tricyclic antidepressant)

Besides medication, behavioral interventions are used. In fact, behavioral interventions are seen as the best form of treatment for this disorder. Behavioral interventions include:

  • Hypnosis
  • Relaxation training, such as deep-breathing.
  • Habit reversal, where a person is taught to be aware of their habit and to use an alternative habit when they feel like pulling their hair out.
  • Cognitive therapy, where a therapist helps a person figure out what inappropriate beliefs may be leading to the hair pulling.

There is no special diet or exercise that may help a person with trichotillomania. However, some medical practitioners believe that people who engage in obsessive hair-pulling seem to do so when engaged in physically passive activities like watching TV, talking on the phone or sitting at a desk and studying. Physical activities help a person to reduce their levels of stress and this may be of benefit to them alongside behavioral and, potentially, medical therapy.

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