Trichotillomania is a hair loss condition and compulsive disorder in which a person pulls out their own hair. This kind of hair pulling can occur to the point that hair loss is noticeable to other people.

Loss of hair is obviously the first and most evident sign of trichotillomania, but what are the other symptoms? Identifying the following symptoms in a suspected sufferer can help your GP or trichologist diagnose the condition properly and distinguish it from other hair loss conditions.

Trichotillomania symptoms

A person with trichotillomania may experience:

• The irresistible urge to pull hair
• A feeling of tension before pulling hair, or when resisting
• A sense of satisfaction, relief or pleasure after giving in to the hair pulling impulse
• Bare patches on the scalp or skin where hair has been pulled out
• Other compulsive body-focused behaviour such as chewing hair, eating hair (trichophagia) inspecting hair roots and excessive playing with hair

The condition is occasionally difficult to diagnose properly because sufferers feel ashamed of their urges and attempt to hide their symptoms and behaviour from others. These people often wear hats, wigs and scarves to try to hide their hair loss.

Female hair loss can have many causes, such as stress, poor nutrition or hormonal changes. However, one often overlooked cause is problems with the thyroid, or thyroid disease.

The thyroid is a gland located in the back of the neck. It is an endocrine gland, which means that it secretes its hormones directly into the bloodstream. The thyroid is responsible for the speed at which the body uses energy and makes proteins, as well as controlling how sensitive the body is to other hormones.

If the thyroid malfunctions, it can cause either hyperthyroidism (overactive) or hypothyroidism (underproduction). Either of these conditions can cause female hair loss or thinning as a secondary symptom, with other symptoms including weight gain, sensitivity to temperature, fatigue and dry, itchy skin.

If you have noticed your hair thinning or falling out, and you think it’s due to a thyroid problem, you must take the following steps:

• See your GP
• Consult or get yourself referred to a dermatologist
• Check that your hair loss isn’t being caused my thyroid medication you are already taking
• Make sure you aren’t being undertreated
• Find out about any nutritional deficiencies which could be making your condition worse
• Consider alternative hair replacement treatments to cover thinning or balding patches

If you are experiencing sudden and significant hair loss, it is likely to have been caused by an interruption to the normal growth cycle of your hair.

Hair follicles go through three stages – growth (the anagen phase), transitional (the catagen phase) and a period of rest (the telogen phase). The anagen phase normally lasts between four to six years, before resting for just a few months.

If the follicles experience too short a growth phase or enter telogen early, this can cause massive shedding or thinning of hair. But what causes this interruption to the normal growth cycle? The most commonly known triggers include:

• Sudden hormonal changes such as those which occur after childbirth
• Acute physical, psychological or even surgical trauma
• Diseases such as lupus and diabetes
• Chemotherapy and radiotherapy
• Burns
• Severe and sudden change to diet
• Thyroid problems
• Certain medications, such as some birth control pills, medication for blood pressure and anti-depressants
• High fever

If you believe that any of the above is causing your hair to fall out, the most important thing to do is to see your doctor, dermatologist or trichologist for a formal diagnosis.

As an adult, losing your hair can be very distressing. As an image-conscious, insecure teenager, however, a hair loss condition can be devastating.

Going to school or college every day and facing the often harsh and insensitive judgement of your peers can be very damaging to the self-esteem of an adolescent with hair loss, which is why it’s important to get a formal diagnosis from the doctor and find out what exactly is causing the hair to fall out.

Hair loss in teens can be caused by a number of factors and conditions, such as:

• A medical condition or illness – i.e. thyroid disease, polycystic ovary syndrome or other hormonal conditions

• Medication – Hair loss can often be a side effect of acne medications or diet pills, both of which are taken by some teens

• Alopecia areata – An autoimmune disease causing patchy hair loss, the onset of which is often linked to stress

• Androgenetic alopecia (pattern baldness) – A hereditary hair loss condition

• Trichotillomania – This is a psychological disorder in which the person feels a compulsive urge to pull their own hair out.

• Poor nutrition – People who have eating disorders such as bulimia or anorexia may be at risk from hair loss