Trichotillomania (Hair Pulling) Support Group

Trichotillomania (TTM), or "trich" as it is commonly known, is an impulse control disorder (ICD)characterized by the repeated urge to pull out scalp hair, eyelashes, facial hair, nose hair, pubic hair, eyebrows or other body hair, resulting in noticeable bald patches.

Trichotillomania is classified in the DSM-IV as an impulse control disorder (ICD), but there are still questions about how it should be classified. It may seem, at times, to resemble a habit, an addiction, a tic disorder or an obsessive-compulsive disorder. Due to social implications the disorder is often unreported and it is difficult to accurately predict prevalence of trichotillomania; 2.5 million in the U.S. may have TTM, with a 1% prevalence rate.

Many clinicians classify TTM as a habit behavior, in the same family as nail biting (onychophagia) or compulsive skin picking (dermatillomania).

Anxiety, depression are more frequently encountered in people with TTM. People with TTM may also eat/chew the roots of the hair that they pull, referred to as trichophagia. In extreme cases this can lead to Rapunzel syndrome, and even death. Some individuals with TTM may feel they are the only person with this problem due to low rates of reportage.

Trichotillomania is a chronic problem; although one can recover from it, there is currently no specific cure. It can be stubborn, but with proper treatment and persistence, picking and/or pulling hairs can be greatly reduced and even brought under control (often called "hibernation").

Habit Reversal Training or HRT, has been shown to be a successful adjunct to pharmacotherapy as a way to treat TTM. Many patients who pull their hair don’t realize that they are doing this; it is a conditioned response. With Habit Reversal Training, doctors train the individual to learn to recognize their impulse to pull and also teach them to redirect this impulse. As a part of the behavioral record-keeping component of HRT, patients are often instructed to keep a journal of their hair-pulling episodes. They may be asked to record the date, time, location, and number of hairs pulled, as well what they are thinking or feeling at the time. This can help the patient learn to identify situations where they commonly pull out their hair and develop strategies for avoiding episodes.