- About Trichotillomania
- UK BFRB Support Charity – Trichotillomania Support
- Why Do People Pull Their Hair Out?
- Trichotillomania Treatment and Skin Picking Services for BFRBs
- Hair Regrowth After Hair Pulling: Strategies and Information
- Understanding Symptoms of Trichotillomania and Other Body-Focused Repetitive Behaviours (BFRBs)
- Diagnosis of Trichotillomania
- Trichotillomania Treatment Research
- The BFRB Scale for Body Focused Repetitive Behaviours
Consultation with a Practitioner about Hair Pulling
Clinical Diagnosis of Trichotillomania
Consultation and Diagnosis
Clinical diagnosis of trichotillomania takes place in consultation with a doctor, clinical psychologist or psychiatrist. If you visit your doctor (GP) for a trichotillomania diagnosis, as well as relying on what you say, they will follow guidelines to rule out other forms of hair loss, possibly referring you to a dermatologist.
Understanding Trichotillomania
Controversially classed as a mental health condition, trichotillomania is often grouped with attention deficit disorder, tics, obsessive-compulsive disorder (OCD), and body-focused repetitive behaviours (BFRBs).
Behavioral Patterns
As the expression “tearing your hair out” implies, sifting through and even pulling individual strands of hair is a natural stress response. If the hair pulling action recurs and does not go away, you can safely say that you have trichotillomania. More often than not, this condition occurs in highly sensitive individuals.
Symptoms and Sensations
Trichotillomania, or compulsive hair pulling, often starts with searching for split-ends or searching for hairs which feel different and encompasses hair-twirling. For many, this is a textural phenomenon. People with trichotillomania often get great satisfaction from rubbing hair on their face or lips, as well as hair stroking and pulling hair out.
Diagnostic Criteria (DSM-V)
The American DSM-V manual states that diagnosis of trichotillomania must include:
- Recurrent pulling out of one’s hair, resulting in hair loss which is not from another medical or dermatological condition.
- Repeated attempts to decrease or stop hair pulling.
- Significant distress or impairment in social, occupational, or other important areas of functioning.
Positives and Negatives of Diagnosis
The DSM is a worldwide accepted diagnostic template for (what are classed as) mental illnesses. The goalposts of such documents move as directed by economics as well as by science. Using worldwide templates such as these, does not take into account environmental influences, the emotional world and history of the hair-pulling individual.
Diagnoses, like anything else, have positives & Negatives
Not all who pull their hair out are mentally ill. The DSM is a starting point for clinicians. People are unique and many people pull their hair out and have no other signs of anxiety. Professionals will hopefully place more emphasis on listening, and less on standardised diagnosis.
Hair Pulling Behaviour
Most people with tric do not have visible bald patches and would not stand out in a crowd. Statistically, there is one person with trichotillomania in every group of 50 people. Many people pick at their skin and twirl or pull on their hair in the normal course of life. For some, hair pulling is an unconscious or subconscious condition while for others there is an urge to pull. Most people with tric can relate to both types of pulling.International Perspectives on Treatment
Similar to OCD, individuals with trichotillomania tend to ruminate. Our experience with British people with trichotillomania has been that social anxiety often precedes and is related to pulling, while those who have presented for our trichotillomania treatment in the USA often present with fewer concerns about social interaction.
Review Dates
Peer-reviewed: 20 June 2024
Next review: 21 June 2026