PULLS OUT HAIR

TRICHOTILLOMANIA

Topics in Mental Health

By Shlomo Y. Radcliffe

What is Trichotillomania?

Trichotillomania (also known as TTM or Trich) is a rarely reported impulse disorder in which a person displays a “passion for pulling hair”. Hair pulling can apply to the hair on the child’s head and/or to eyebrows and/or eyelashes. Generally children with Trichotillomania do not feel any pain when pulling out a hair, although they may sometimes feel a small twinge. Increased symptoms tend to occur with increased stress. Excessive hair-pulling can result in patches of baldness.

Symptoms of Trichotillomania (DSM-IV Criteria)

In order to diagnose a child with Trichotillomania the child must have the following symptoms:

• The child’s repeated pulling out of hair causes hair loss.
•  The child feels an increased build up of tension just before pulling out his or her hair or when resisting the urge.
• The child feels pleasure during hair pulling.
•  These symptoms cause significant distress or impair personal or social functioning.
•  The behavior is not better accounted for by another mental disorder and is not caused by a medical condition.

Treating Trichotillomania

Treatment for Trichotillomania involves two many interventions: habit reversal training (behavioural therapy or cognitive-behavioral therapy) or a type of pharmaceutical treatment such as serotonin reuptake inhibitors (SSRI’s like Prozac or Zoloft) or clomipramine. Since some medications are not recommended for children, parents may also consider looking into alternative treatments that facilitate stress-reduction as an adjunct to therapy. For instance, yoga, Bach Flower Therapy, herbal medicines, relaxation training, mindfulness meditation, homeopathy and other naturopathic modalities may be of some value to children suffering from any stress-related condition.