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What Causes Trichotillomania & What Can Be Done About It?

What is Trichotillomania?

Trichotillomania which in common terms is known as a habit of pulling the hairs is a psychiatric disorder which can be quite disabling for the individual and can result in functional impairment. Constant pulling of hair leads to hair loss. The medical literature considered Trichotillomania as a medical problem but did not include it in the list of psychiatric disorders until 1987 [1].

An individual is said to have Trichotillomania if he or she indulges in behaviors where there is pulling of hairs constantly causing hair loss and damage. This pulling of hair becomes a problem for the individual in the social and professional environments resulting in significant distress. An individual is also said to have Trichotillomania if there is no other medical explanation for hair loss or hair pulling identified by the treating physician [1].

Another diagnostic criterion for Trichotillomania is that the hair pulling behavior is not explained by any other psychiatric disorder such as pulling hair to improve facial appearance or for other cosmetic reasons. Once all the above mentioned diagnostic criteria are satisfied the individual is said to be having Trichotillomania. Now what exactly causes this condition and how to deal with it is what has been explained in the article below [1].

What is Trichotillomania?

What Causes Trichotillomania?

As there has not been much research done in this domain the exact causal factors for Trichotillomania is not fully understood or known. However, majority of the researchers are of the opinion that both genetic and environmental factors play a role in the development of Trichotillomania. Studies suggest that some people are genetically predisposed into developing Trichotillomania, although why it happens still remains to be understood [2].

Another study mentions that even though the first degree relatives of an individual with Trichotillomania are at risk for developing this condition it is extremely rare that they actually develop it. Anxiety also has a role to play in the development of Trichotillomania. In fact, some people state that they find pulling of hair quite relaxing while some others do it when they are stressed [2].

Some studies suggest that an abusive childhood also increases the risk of an individual developing Trichotillomania even though there is hardly any evidence to prove it. Some studies suggest an abnormality in the functioning of the brain also may cause Trichotillomania [2].

These abnormalities include minute changes in the putamen, the cortical regions, or the cerebellum. These are the regions of the brain which play a role in development of habitual behaviors. However, this theory requires more research in order to be considered as a potential cause for Trichotillomania [2].

There are also some researchers who believe that Trichotillomania is a variant of OCD which is caused by changes in the chemicals within the brain. All in all, the data that is available is not sufficient enough to pinpoint any one possible cause for Trichotillomania [2].

What Can Be Done About Trichotillomania?

The question now is what can be done about this condition. There are two ways by this Trichotillomania can be stopped namely psychotherapy and medications.

However, the efficacy of both of these forms of treatment is variable and not all people have claimed benefit from these approaches [2].

Under psychotherapy, the most preferred approach towards treating Trichotillomania is cognitive behavioral therapy. In this therapy, the thoughts and emotions behind such behavior are identified and ways are devised to treat them. Coming to medications, there have been host of medications that have been tried to treat Trichotillomania with varying success [2].

There have been some clinical trials done of which one has shown that the drug clomipramine, n-acetyl cysteine, and olanzapine have had some positive effect on people with Trichotillomania. Among all the three medications, n-acetyl cysteine has been very well tolerated [2].

Additionally, behavioral modifications have also been tried with some success in people with Trichotillomania in addition to the medications. Research is still ongoing for determining specific therapies that can be used either in combination or alone for treatment of this behavioral disorder.


Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:October 12, 2019

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