What Is Trichotillomania?

Trichotillomania is classified as an impulse‑control disorder. Individuals experience recurrent urges to pull out their own hair, often from the scalp, eyebrows, or eyelashes. The condition can be deeply distressing and may significantly affect emotional well‑being, daily functioning, and self‑esteem.

Common Symptoms

People with trichotillomania may experience:

• Repeated pulling out of one’s hair, leading to noticeable hair loss
• A rising sense of tension or discomfort before pulling, or when trying to resist the urge
• Feelings of pleasure, gratification, or relief after pulling
• Symptoms that are not better explained by another medical or mental health condition
• Distress or impairment in social, occupational, or other important areas of life

How and When Does It Begin?

Trichotillomania often begins around ages 12–13, though it can start earlier or later. In many cases, the onset is associated with stressful or emotionally charged events such as:

• Changing schools
• Family conflict
• Abuse
• The death of a parent
• Puberty‑related hormonal changes

Does Trichotillomania Lead to Other Challenges?

Adolescence is a sensitive time for developing identity, body image, and peer relationships. Even small areas of hair loss can lead to:

• Shame or embarrassment
• Ridicule from peers or family
• Avoidance of social or intimate relationships
• Long‑lasting emotional effects

Many individuals with trichotillomania go on to lead full, healthy lives. However, some may struggle with secrecy or fear of being “found out,” which can affect relationships and self‑confidence.

What Causes Trichotillomania?

The exact cause is not yet known. Current understanding suggests:

• A biological component involving brain chemistry
• A possible genetic predisposition
• Stress or environmental triggers
• Different causes in different individuals, similar to how many medical symptoms can arise from multiple conditions

More research is needed to fully understand the condition.

Relation to Other Conditions

Trichotillomania often occurs alongside other concerns, including:

• Obsessive‑Compulsive Disorder (OCD): Some individuals experience compulsive counting, checking, or washing.
• Depression: This may be related to underlying neurobiology or to the emotional toll of chronic hair‑pulling.
• Other repetitive behaviors: Nail biting, thumb sucking, compulsive scratching, head banging, or skin picking.

These co‑occurring behaviors can contribute to both physical and emotional distress.

Treatment Options

Two approaches have shown benefit in research:

Behavioral Therapy

Structured behavioral therapy helps individuals:

• Track symptoms and triggers
• Increase awareness of pulling behaviors
• Learn alternative, incompatible behaviors
• Build skills to interrupt the pulling cycle

Medications

Some medications may help reduce symptoms such as depression or obsessive‑compulsive tendencies. However, symptoms often return when medication is stopped unless therapy is also part of the treatment plan.

A Positive Approach to Hair Loss

Losing hair—whether from trichotillomania, medical treatment, or another condition—can be emotionally challenging. You’ve lived with your hair your entire life; it’s part of your identity. When hair loss becomes visible, it may raise questions about how to explain it, or whether to explain it at all.

Planning ahead can make the transition easier. Securing a prosthetic wig or hair system before significant hair loss occurs allows you to adjust on your own terms. It gives you control, privacy, and time to choose what feels right for you.

Your medical team is the best resource for guidance on the underlying causes of hair loss. And when you’re ready for compassionate support with a prosthetic solution, Studio Hair® Prosthetics is here to help you navigate the journey with dignity, comfort, and confidence.