Trichotillomania and Hair Loss

While most people blame their genes or their hormones for hair loss, there is an unfamiliar condition which also causes hair thinning and baldness, and the reason for it is related more to the inflicted person’s psyche than anything else. You may have encountered this condition before as a child, or you may be suffering this now to a certain extent without even being aware of it. While the notion that hair pulling causes baldness seems to be far fetched, the truth is that more people suffer from it more than you think.

It’s clinically referred to as trichotillomania, the obsessive-compulsive tendency of a person to pull their hair strands (and in some cases ingest them). Although the condition affects both genders and all ages, women possess a greater tendency towards it, especially young girls. The exact reasons for this condition is practically unknown, but it is presently closely linked to stress, and is considered to be of the same psychological roots as nail biting or unconscious fidgeting. It is not uncommon in other animals as well; horses and dogs sometimes tend to eat their tails, and animals at bay tend to pull out fur or plumage. In humans, the condition can be a preexistent psychological one; otherwise, it can also be a developed habit.

Early symptoms of trichotillomania may occur at any age, but usually during the age of infancy or puberty. There is always an involved urge to pull the hair, and tension almost always precedes the act itself, followed by a sense of relief after it. Since most people who suffer this condition obtain pleasure with hair pulling, the act is repeated until the scalp becomes bald in patchy, uneven regions. If the person also observes the habit of eating pulled strands, this may develop bowel obstructions as well. An obsessive-compulsive trichotillomaniac also denies that he or she is such, making treatment rather difficult for severe cases. Trichotillomania is a purely psychological problem until hair and scalp damage results in consistent tension, or if the person becomes too preoccupied with the habit that he or she loses touch with the surroundings.

Since trichotillomania is basically a psychiatric condition, behavioral training is the best way of treating it. This may come in three stages: competing response training, where the patient exerts a mental effort to fight the urge to continue the habit; self-monitoring methods, wherein he or she keeps track of development or relapse during the training; and a display of improvement, a stage wherein the patient is deliberately exposed to conditions which may cause a relapse, in an effort to evaluate the improvement. There are also certain medications which can help minimize the urge (like valproate, fluexetine, and sertraline, among others); however, these are known to be ineffective in themselves since the condition relapses once the medication routine is stopped. A combination of both treatment methods is thus recommended. And since the actual cause of trichotillomania is as yet undetermined, only self-discipline and appropriate medical attention can effectively deal with the habit. Fortunately, the hair loss which is experienced with the habit is temporary, and the scalp regrows a full head of hair once the urge is completely overcome.