Trichotillomania – Hair Pulling Caused by More Than Stress by Ariel Taylor


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Trichotillomania is described as compulsive hair pulling and is a complex condition. Contrary to popular belief, it is not triggered by stress and anxiety alone. In addition, it is far more common than people think. The degree to which sufferers experience the condition may vary.  But it is believed that about 2% of the population experience trichotillomania. For some, it becomes a permanent, debilitating condition. It attacks the self-confidence of sufferers and adds to the stress and anxiety they already feel.

How trichotillomania develops in some individuals and not others is a question not easily answered. Experts believe the condition has its roots in the genetic make-up and hormone count in the body. Add to that the psychological aspect of the regulation of emotions, and a less than ideal environment, and you’ve got the right mix for trichotillomania.

A person with a genetic predisposition toward any Body-Focused Repetitive Disorder (BFRD) has a higher chance of developing trichotillomania. Other BFRD’s include cheek biting, skin picking, nail biting, and thumb sucking. Studies are being conducted into the possibility that fluctuating hormones may be responsible for the onset of trichotillomania. The reason for this suggestion is that trichotillomania often begins as a child enters adolescence.

The brain’s ability to process and manage emotions may also be a cause of trichotillomania. The condition is driven by an inability to regulate emotions. There is a range of motions that can trigger trichotillomania. Feelings of anger, fear, stress, anxiety, boredom, or excitement may cause a trichotillomania response. When these factors are coupled with an environment where stress and other emotions run high, a person can develop trichotillomania.

Trichotillomania can also be a response to a particular experience. Some sufferers say its onset was brought about by a haircut they didn’t like. Appearance is a very sensitive subject among adolescents. So, when they are teased about a haircut, it affects them. That’s not to say that every child who is teased about their hair will develop trichotillomania. But for some, it can trigger an episode, which then develops into a lifelong condition.

The reasons for trichotillomania are as different as the factors that drive it. Treatment for it and teaching techniques that address how to stop pulling out hair will therefore also vary. Some people describe hair pulling as a way of eradicating feelings of stress. It gives them a sense of control to pull their hair out. Others do it to eliminate hairs from their head that they feel are less than perfect. They consciously seek these hairs out and selectively pull them out. This is called focused hair pulling. The person sets aside a certain amount of time of their day to pull out hair. They derive a sense of satisfaction or relaxation from hair pulling. Some trichotillomania sufferers pull out random chunks of hair without even knowing they’re doing it.

Before any treatment can be prescribed, the cause of the trichotillomania must be established. There are various treatments (see, which are usually a combination of medications and psychotherapy. Medications can alleviate some of the irresistible urges to pull their hair out. Psychotherapy teaches the sufferer how to manage the triggers that cause them to start pulling out their hair. Trichotillomania patients are urged to find a therapist with some knowledge and experience in dealing with the condition. There are also support groups that patients can join to share their experiences. Many feel that the support and advice of other sufferers are helpful to them. It helps them to deal with the social stigma of trichotillomania. There are also plenty of websites that offer advice for trichotillomania sufferers.

Because the condition is not well-known, and few people talk about it openly, the stigma is a huge challenge to sufferers. Being ‘caught in the act’ or having bald patches on the scalp from hair pulling stimulates prejudice against people with mental illnesses.  Those who are not educated about the condition assume it’s purely related to stress. It comes from the saying “I’m so stressed out I want to rip my hair out.” These people cannot see beyond that to the complexities of trichotillomania and what causes it. They also accuse the person of being weak-minded as they cannot manage their stress or control their behavior.

This type of ignorance drives the trichotillomania sufferer to keep their condition private for fear of judgment. It also keeps the stigma alive. This limits people’s ability to learn about the condition and what causes it.




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