Trichotillomania - Background Information

Click on one of the links below or scroll down for more information:

• What is it?
• Symptoms of Trichotillomania
• Triggers for hair pulling
• Origins of the term Trichotillomania

Trichotillomania is the compulsive urge to pull out your own hair, which leads to hair loss. Most sufferers are female, but interestingly, around one or two people in every 50 will pull out their hair at some time in their life.

Hair pulling is up to 10 times more common in girls around the ages of 12-13 than in boys, and by adulthood, around 12 females to every one male seek help for Trichotillomania. However, many don't seek help and hide their behaviour for years because of feelings of shame, embarrassment and depression.

The length of an attack tends to vary greatly, with people pulling out just a few hairs over several minutes, or in other cases spending hours or even a whole night stripping the scalp.

The awareness of pulling can also vary considerably – some people pull quite consciously and deliberately and sometimes report that it gives them a feeling of control which is otherwise lacking. Others do it while engrossed in other activities such as reading or watching TV and sometimes appear to be in a kind of trance.

In some cases, often depending on their age, the sufferer can hide their actions for a surprisingly long time. A parent will often notice the effects in a younger child but a teenager may be able to avoid detection for much longer. However, once it becomes known the condition can affect an entire family - the puller becomes the focus of much attention, some of it not at all positive.

Trichotillomania patients often say that their condition is not understood by those close to them, nor by the medical community. This can lead to further feelings of isolation.

Trichotillomania is one of a group of impulse control disorders, which means that although you don’t want to pull your hair, you simply cannot help yourself. The problem is exacerbated once a hair root has been plucked several times because it then becomes desensitised, just as it does when you frequently pluck your eyebrows or have a leg and bikini wax.

This loss of feeling explains why people start pulling out their hair from wider and wider areas, because the feeling of relief gained from the original point is lost.

Symptoms signs and side-effects of Trichotillomania

• An irresistible urge to pull hair
• Noticeable hair loss from recurrent pulling
• An increased feeling of tension prior to pulling out the hair or when trying to resist an attack
• Feelings of pleasure, gratification or relief are derived from pulling
• Possible pulling of hair from more than one area on the body
• A feeling of guilt afterwards
• Being aware that if it stopped there would be a benefit to you

It’s thought that major upheaval in life such as abuse, bullying, divorce or death can often trigger Trichotillomania. Exam stress is often quoted too. But while hair-pulling may provide a short-term distraction from possible personal problems such as depression, anxiety, dependency and anger, the pulling can fuel a new cycle of these feelings, creating a vicious circle that is difficult to cope with.

In those who are conscious of their pulling the following are often mentioned as reasons for initiating a pulling session.

• Searching for hairs that feel different - thicker or coarser
• Feeling some hair is the "wrong colour"
• Ritualised pulling of hair until the "right" hair has been found or pulled

Hair pulling appears to have been around since the beginning of time, and is mentioned in the Bible (Job, Ezra 9, verse 3), in the writings of Hippocrates the Greek father of medicine which dates from 400 years BC and also in Homer’s Iliad. Even in today's religion, the Jain sects of India still require devotees to pull out all their hair to help them reach spiritual awareness through pain.

The term Trichotillomania (a combination of three Greek words) was first coined in 1889 by a French dermatologist Hallopeau after he encountered a young male patient who tore out every hair on his body in response to an intense itch.

At Lucinda Ellery we aren't fond of the term as the "mania" part suggests a type of behaviour that is seldom if ever present in most women who suffer from it.

There are several contrasting theories behind the growth of Trichotillomania in modern society. Some point to genetic trends, chemical imbalances in the brain due to traumatic events, or events in the womb. As some antidepressant drugs can relieve the urge to pull, many believe sufferers experience a miscommunication of chemical messengers (neurotransmitters) in the brain.