May 3, 2007


hair twiddling, hair pulling , skin picking,
eyebrow & eye-lashing pulling

Definition: Trichotillomania is hair loss caused by compulsive pulling and/or twisting of the hair until it breaks off. The hair may be lost in round patches or diffusely across the scalp. The effect is an uneven appearance. Other hairy areas may be plucked, such as the eyebrows, eyelashes, or body hair.

You may think I have gone off my rocker with this subject . . . but to be perfectly honest it is more prevalent than many think. It has been estimated as high as 10% of the population being affected by it... & when you look at the numbers of hair loss : 90-95% of all female hair loss is TEMPORARY, 5% is permanent and another 10% is "Trich"...that is a helluva lot of people. So with the whispering responses I have had over the years I know how many of the secretive sufferers are out there. I am interested in helping them as well, it is still a hair problem that needs focus on it.
Basically it is an OCD ( obsessive compulsive disorder).

Alternative Names:
Compulsive hair pulling, hair twiddling, skin picking,

Causes, incidence, and risk factors:
Trichotillomania is a type of compulsive behavior and its causes are not clearly understood. Symptoms usually begin before the age of 17. It may affect as much as 10% of the population. People with this disorder will often seek the help of a dermatologist initially. Women are 4 times more likely to be affected than men.

Why do I pull my hair out?
. . . . because they have this disorder called trichotillomania. 80% of trichsters report an itch-like urge to pull and there may well be a cause similar to folliculitis (inflammation of the hair root) or an irritation to the very natural and normal skin yeast, Malassezia. There are usually, however, substantial emotional issues which may preceed the irritation and benefit from
Trichotillomania typically begins at puberty, when the stress hormones and skin oils which exacerbate Malassezia are at their highest. There is no doubt that stress triggers trichsters to pull more, so developing strong stress responses does help in controlling the urges. A sophisticated blend of skills, needs to be balanced to reach full recovery.
Some regular visitors to this site have had trichotillomania for a number of years and have successfully balanced all the information gleaned here, to achieve pull free status, permanently.
For trichsters, the pulling brings relief and is not at all painful. It is generally felt to be soothing. Most report feelings of guilt and shame surrounding their hair pulling.

These are ideas that have helped others to stay pull free -

Exposure to Sunlight
Playing my

Acceptance of my condition
Cutting out sugar, glucose caffeine and popcorn.
Getting up and doing something to take my mind off it
Covering my scalp with shampoo, lotion and hair conditioner (all mixed)
Playing with Beanies
Keeping a diary
Getting lots of sleep
squeezing a stress ball
Wearing a hat
working out
Having false fingernails makes gripping impossible
Not being alone
Taking a long hot shower
Rug making
Silly Putty
Wet hair
Wearing gloves
Stop 'n Grow
Colouring or drawing
tapestry or cross stitch
talking to other

throwing away the tweezers
Being involved and active
Having my hands occupied
wearing plasters on my fingertips
Going for a walk
Playing good music and dancing or singing,
Going out somewhere public
taking a hot bath
studying at the library rather than home
plenty of sleep
Eating bananas
taking potassium supplements
Staying away from people who put me down
I keep my correspondence in a box by the television so I can write cheques, pay bills and write envelopes while watching.
Eating a pomegranate. It takes AGES and you can watch a whole film while picking at the seeds. Sunflower seeds also occupy the hands.
Pairing my socks while watching TV
Reading only in public - i.e. on a bench in a park.
Sorting my sewing box while watching TV
I only allow myself 30 mins of TV at a time. I can manage to stay pull free for 30 mins
Stroking a pet
Asking for what I want.
making patterns with pins in a pin cushion, then pulling them out and starting over again.
I keep my nail polishes by the TV. Polishing my nails gives me time to refocus on something else and forget my urge to pull.

These symptoms are usually seen in children:
constant tugging, pulling, or twisting of hair
increasing sense of tension is present before the hair pulling
sense of relief, pleasure, or gratification is reported after the hair pulling
hair pulling leads to an uneven appearance
bare patches or diffuse loss of hair
hair regrowth in the bare spots that feels like stubble
some individuals may develop a bowel obstruction if they eat the hair they pull out
other self-injury behaviors may be present

People suffering from this disorder often deny pulling out their hair.
I was shocked the first couple months, when first seeing clients within the privacy of the hair loss clinic,not at the disease, at how prevalent it is. This is a much more common problem than I had ever realized, or had ever encountered within the walls of the Salon or Lab...which is not bad, just surprizing. As I studied up, learning all I could about the syndrome, I realized that I had 2 people within my own personal world that most likely qualified for at least a minor version of the issue. We call it Trich. now at the clinic (Trick) and the clients with it: "Trich-sters"...we actually 'borrowed' the nick names from the most helpful of all web sites devoted to the issue, the one that is based in the U.K. www.
Trichotillomania assoc. United Kingdom .

If anyone is suffering from this... our single best advice is to join the online membership of this society, and log into their support center, they have tremendous research and support, their program is dynamic, loving, innovative and most of all > successful. You can see why, within the first few minutes of logging in, its one of those gold mines of the Internet.

Not only is more likely to occur in women but it most likely to occur around puberty or menopause. I had one young woman who had been pulling her hair for about 9 years, starting right after puberty & the first case I ever saw was a 51 year old woman.

Trichotillomaina occurs when the twiddling gradually reaches the pulling stage, whereby the hairs are repeatedly pulled out one by one, eventually causing a thin or bald patch that can cover quite large areas. Its the hairs which cause momentary pain when pulled that are fully pulled out - so they test each hair first by pulling to see which one might hurt most, then tug it out.The satisfaction of this encourages them to pull out another one and so on. It can go on for years because the hair from the pulled follicle grows back - at least at first. It's interesting though, that the pulling takes place in areas which can be more easily camouflaged and covered with hair that is left. However, there have been cases where almost all the hair has been pulled out,only leaving a fringe around the head - almost like a halo. Furthermore women with thicker more luxuriant hair seem to be more prone.

There can be deep psychological and sexual undertones in this condition: from mild masochism, sexual gratification and attention seeking ( because those close to the perpetrator (so to speak) are usually aware of the hair loss, don't know why its happening, are sympathetic, worry about them and pay them more attention).
The sufferer becomes more and more perturbed about the loss of hair, knowing that they are solely responsible but unable to find a way to break the habit. However the sufferers rarely admit to it and they usually need delicate negotiation to let them know that you care which is why I find the British web site so effective.

It is truly a difficult habit to break. Occasionally psychological therapy is needed. There are other ways that require a lot of time and patience too. One trick is to wear thick gloves during temptation times, especially at night ( when the condition may be at its peak of temptation), so that the hair cannot be gripped. Another is to cut it very short so it is impossible to get a hold of; or cover the hair with a slippery cream or oil; wear a scarf over the head; or a combination of the two or more of these solutions. Its a matter of interrupting the habit..sometimes playing with video games or knitting takes the mind off playing with the hair.

The process reminds me of trying to get a child weaned off of the bottle or the pacifier....which is one theory I personally have about it. I think women have a sort of oral fixation that is not totally satisfied around those ages that it is the most predominant. Many women seem to go through the change in their sexual drive around both of the milestones (puberty & menopause) I think that is somehow tied into the craving to do it. There are just too many people with this affliction for there not to be some substantial theories in regards to it. Currently there are a number of Clinical Trials going on in regards to the Syndrome, so it will be months/years before we receive the results. . . but I expect some radical new theories with each one.

The condition is often misdiagnosed as it looks a lot like Alopecia Areata, a hair loss occurring in patches, which can look very similar. The reluctance by many to admit to the real problem that "they' are the ones pulling it out leads to misdiagnosis. The whole entity is very very secretive and private...they want to keep it all to themselves, which is another underlying psychological aspect of the overall condition.

Support for "Trich.sters"
The following contains some crucial advice concerning how you can support someone with trichotillomania.
It is nothing you have done that causes a person to pull out hair. Trichotillomania is a disorder. A person with Trich is a NORMAL person who has a disorder. Any loved one would want to solve the problem … but the solution ALWAYS comes from the person themselves and the best you can do is to empower them to make their own decisions.

You don't have to understand, and certainly don't have to pretend that you do. Listen, without making suggestions or offering advice. Supply plenty of praise, hugs and above all, acceptance.

Offering praise will boost the Trichster's self-esteem and someone who feels good about themselves, is less likely to self abuse. You cannot control the pullers actions, but you can control your own reaction to it. Be strong, be positive. Be accepting.

Please try to treat Trich as a disorder separate from the person. The Trichster is a terrific person, deserving of a lovely, full head of hair and eyebrows and eyelashes to match.
Pulling probably remains an issue for life. Some days it's unnoticeable and other days rampant.
However deeply it hurts you, this isn't about you, and the Trichster hurts a million times more. They blame themselves enough and don't need more blame from you! This isn't a habit. It isn't something people deliberately do … it is like being taken over by a trance. Scalp pullers often feel like there are tiny insects crawling under the skin and the itch creates an urge to pull.

You've tried ignoring, shouting, distracting … but each individual must heal themselves. You can't do it for them. I know that hurts like hell and it's okay. If you need to get your anger out, write letters to the Trichster that you later burn without sending but always appear supportive.

Trich hurts like hell when it's at its worst, but it overwhelms you with its warmth too. Most Trichsters form loving, caring relationships and function well in all other areas of their lives.
So what should you do when you're sitting down comfortably in your warm environment, perhaps watching television, and out of the corner of your eye you notice someone pulling?
Distraction would help ... hand them a cup of tea (sorry, English answer to everything!), or ask them to check some figures for you. Engaging the logical brain can often stop the subconscious pulling process. Invite them out for a walk. Getting out or even just moving from place to place, helps. Reading and watching TV are triggers for pulling. Play chess, computer games or anything which involves the hands. Cross stitching is helpful. Try to keep them active and interested. Boredom is really bad for Trich.

Incentives help, but please, if you've promised a reward, don't withhold it if there has been a little relapse. Try to be understanding that Trich is not always within the person's control.
Take care of your loved ones and look after yourself.
6 comments on "Trichotillomania"
  1. Thank you so much for posting a topic about this.
    I've recently read A LOT of information about trich, completely fascinated with it because I knew I pulled my hair but I never knew there was a name for what I did.
    I still have my own issues stopping, and currently have a small bald spot on the top of my head. It's really depressing. :[ Especially having thick, red hair that people almost always commented on before, but now it feels like nobody says anything. I always wonder if people laugh at my frizzy hair because it's growing back in random spots and sticking up everywhere. But it helps to know that more and more people are becoming aware of it and passing along information. There is no cure and it's actually more of an impulse control disorder rather than an obsessive one. I'm not sure what the difference is, though. :/ But yeah. Just wanted to say thanks. :]

  2. Your welcome girl...
    I'm glad...
    you know what? you are the 3rd person to thank me this week for this post, I want to continue on this subject , its a helluve lot more commmon than people realize and its shoved under the mat and I don't like that...
    I would suggest you visit that site in the UK, they ( of course) are light years ahead of us...and are having great sauccess with their group. Its a very warming and welcoming group just take a look....
    Killer Chemist

  3. I have been snapping breakage spots and split ends off and also running my fingernails down the hair shaft. I know this has caused the breakage and uneven lenghts in my hair. I just think it happenes more when I am not happy or having trouble with my relationship, it always happens more when am not busy enough. Its like I cannot stop in the car I see all this hair down on the floor next to the door. Its embarrassing! I want long hair so bad, this is very hard to stop. I was doing this in 5th grade a teacher threatened to cut it off if I would not stop. I really is sad. help! And I love you for all the information you provide us and your products are out of this world! God Bless You!!!!!!!

  4. Recognizing that I actually was suffering from a disorder and then becoming very aware of when I was pulling was key for me. I also developed my own serum to help me and after 35 years finally became pull free. What liberation! I now have a support site too - The most important thing is know that YOU CAN STOP PULLING!

  5. Amy, Thank you for being so brave and talking about this as it is a widespread problem...much more common than people think. I even have one of my own physicians who has the affliction. So stay in your group and anyone else visiting this post be sure to check it out as well ! Again, Thanks so much for your post.


  6. Thanks so much for this great article. I started pulling late, I was about 22 when I started, easily hidden, and it would come and go, and now I'm 32 and it's very serious, about 75% of my scalp has been pulled and regrowing patchy. My husband tries to remind to not pull but sometimes he yells. I crochet a lot as a distraction and it helps, and I have some dermititis that is tied to the pulling but right now it is slow going.
    It's nice to know that you aren't alone.


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