Trichotillomania (TTM)

Trichotillomania affects 1-2% of the population, over 2.5 million Americans. The mean age of onset is 9-13 years old. There are two types of pulling, namely ‘automatic’ and ‘focused’ pulling. Automatic pulling is when the person engages in the behavior habitually and without premeditated intent, whereas focused pulling is when the individual makes a conscious decision to pull.

Trichotillomania is recurrent non-cosmetic hair pulling that results in significant noticeable hair loss. The person experiences increased tension immediately before pulling or when attempting to resist the behavior. The person experiences pleasure, relief of anxiety or gratification when pulling out hair.

Symptoms may include:
  • Chronic hair pulling on head, face, arms, legs and other areas of body
  • Pleasure in pulling hair
  • Relief of tension after pulling
  • Excessive examination of pulled hair
  • Eating of hair
  • Preoccupation with hair pulling or resistance of pulling

Causal Factors:
Biologic, Genetic, and/or Sociologic factors. Can be accompanied by Anxiety Disorders and/or Depression.

Treatment Options:
Cognitive Behavioral Therapy, Exposure and Response Prevention, and/or Medication.