Trichotillomania - The Compulsion to Pull Out Hair

What is Trichotillomania (pronounced trik-o-till-o-MAY-ney-uh)?

The word is derived from the Greek thrix, hair; tillein, to pull; and mania, madness or frenzy. The May Clinic defines trichotillomania (also known as trich or hair-pulling disorder) as "a mental disorder that involves recurrent, irresistible urges to pull out hair from your scalp, eyebrows, or other areas of your body, despite trying to stop." In other words, trich is a deep compulsion to pull out one's hair.


As many as 4 percent of people may have trichotillomania, according to the National Institutes of Health.  The compulsion to pull hair out seems to be more common in women, but this could be because women are more likely to seek treatment or medical advice. Experts think the numbers could be higher because many people never speak of this disorder or seek treatment. The thought of being misunderstood by society has many suffering from trichotillomania taking great strides to keep their illness secret.

Trich is characterized by the chronic compulsion of pulling out one's own hair.

  • An impulse control disorder along with kleptomania, pyromania, and pathologic gambling.

  • Classified as part of the obsessive-compulsive spectrum according to the Diagnostic and Statistical Manual of Mental Disorders (DSM).


People with these types of disorders cannot control the urge even though they are aware they may cause damage to themselves. Some pull out their hair when they are stressed as a way to attempt to soothe themselves. In many cases, trich can lead to bald spots and even skin irritation.

Symptoms and results of trichotillomania may lead some suffering from the disorder to isolate themselves.

DSM criteria or symptoms for compulsive hair pulling:

  • Recurrent pulling out of one's hair resulting in noticeable hair loss

  • An increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior

  • Pleasure, gratification, or relief when pulling out the hair

  • The disturbance is not better accounted for by another mental disorder and is not due to general medical conditions (e.g., a dermatologic condition)

  • The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning

For people with trichotillomania, hair pulling can be:  

  • Focused - Intentional to relieve tension or stress and sometimes creating elaborate rituals for pulling hair, such as finding the "right one" or biting pulled hairs.

  • Automatic - Pulling hair without even realizing it when bored, reading or watching TV.

Some people may demonstrate both focus and automatic tendencies of compulsive hair pulling depending on the situation or mood.

Etiology - Causes

According to the Mayo Clinic "the cause of trichotillomania is unclear. But like many complex disorders, trichotillomania probably results from a combination of genetic and environmental factors."

·         Family history - genetics may play a role in the disorder.

·         Age - usually develops just before or during early teens.

·         Other disorders - people with trich may have other disorders.

·         Stress - severely stressful situations may be a trigger for some.

If you are dealing with trich, there is are others dealing with the same disorder. You are not alone. 

If you are looking for ways to help with the compulsion for hair pulling, read our article from December 2017 titled "What Can Help Trichotillomania?".


Kaitlyn Blair