Hair Pulling Triggers
We asked 11,000 people who have BFRBs, mainly Trichotillomania and Dermatillomania:
“What usually triggers a pulling or picking spree for you?”
After reading the results, please complete the questionnaire yourself, to keep our research up-to-date.
The 20 most frequent responses were (in order of prevalence) stress (48%), boredom (34%), anxiety (13%), watching TV, reading, sitting down, thinking, nerves, being alone, worry, work, tiredness, depression, upset, using the computer, driving, being ill, itching, certain foods and looking in mirrors
We categorised the results into the following 6 groups: Anxiety, Situational, Boredom, Physical, Emotional and Habit.

Figure 1.1: Pie Chart depicting most prevalent triggers of hair pulling behaviour
The Pie Chart depicts the proportion of the 6 groups of most prevalent triggers of hair pulling behaviour compiled from a self-reported list of triggers from 11,000 people with the hair pulling condition, trichotillomania.
Below is a list of contents for the 6 groups. Each list is ordered so the most frequent trigger appears first.
ANXIETY
Stress, anxiety, tension, thinking, nerves, worry, to relax, problems, pressure, fear, take mind off things, excitement, deadlines, socialising, restlessness, financial worry, appearance worry, to unwind, angst.
SITUATIONS
Watching TV, reading, sitting down, at work, using computer, by self/on own, driving, in bed, studying, at home, on phone, concentrating, at school, during exams, looking in mirror, with family, when busy, writing, in bathroom, focussing, procrastinating, evenings, deadlines, traffic, revision, in private, travelling, tweezers.
BOREDOM
Boredom, being alone, not keeping hands busy, relaxing, being idle, waiting, traffic, day-dreaming, free time, zoning out, inactivity, procrastinating, absent-mindedness, spare time, escapism, avoidance, unwinding.
PHYSICAL
Particular hairs, tiredness, feeling ill, particular lash, itch, lack of sleep, at night, long hairs, urges, eating certain foods, re-growth, period, hairs out of place, spots, pimples or bumps, pain, different hairs, irritation, sugar, roots, fatigue, thick hairs, mascara, soreness, caffeine, split ends, short hairs, prickly feeling, food, drink, white hairs, insomnia, alcohol, stubble, tingle, exhaustion, greasy hair, hormones, ingrown hairs, shaving, texture, allergies, burning, drugs.
EMOTION
Feeling bad, loneliness, depression, upset, anger, sadness, frustration, emotions, mind, lack of control, family, feeling low, arguments, for comfort, happy, mad, parents, fighting, hurt, overwhelm, relationships, negativity, guilt, change, mood, insecurity, bad day, feeling ugly, crying, confusion, embarrassment, distress, bullies, confrontation, father, abuse, escapism, criticism.
Anything, I don’t know, habit, it’s constant, not conscious of it, it’s automatic, routine, ritual.
Updated 30 July 2022, review 1 August 2023