Trichotillomania is uncontrolled hair pulling on the head or on other parts of the body, leading to hair loss and balding. Trichotillomania literally means “the urge to pull hair.” About 2% of the population suffer from this disorder, although people who have it hide their condition and rarely seek professional help. They feel guilty because they can not cope with their problem and experience shame caused by a cosmetic defect. What signs help to recognize trichotillomania in people and how to treat this disorder?
What causes trichotillomania?
Causes of trichotillomania are not clear today. Experts argue what it is and whether this disorder is a mental illness. Trichotillomania resembles an obsessive-compulsive disorder when a person performs compulsions in order to get rid of anxious thoughts. For example, several times he backs home in order to make sure that he turned off all electrical appliances.
Trichotillomania is also a way to get rid of negative thoughts but there is a significant difference: a person experiences a kind of pleasure from hair pulling. In addition, studies have shown that the risk of developing the disease is higher in families where it has already occurred. Thus, heredity is one of the main causes.
The following causes may trigger this disorder:
- the death of a loved one;
- change of school;
- parents’ divorce;
- the beginning of an independent life;
- change of job.
While pulling hair, a person tries to escape from unpleasant experiences and feel satisfied. Trichotillomania has deep instinctive roots since such behavior is common in domestic animals and birds.
Trichotillomania in some people is one of the manifestations of perfectionism. They seek out “imperfect” hair that looking too thick, short, curly, different in color from the rest and pull it. Gradually this action becomes a habit.
Symptoms of trichotillomania
Trichotillomania is not only hair pulling on the head. A person may pull eyelashes, eyebrows, beard, hair in armpits and limbs. People who pull hair in the genital area do not seek help since they are very ashamed.
Some people pull hair on others or different items: close ones, pets, etc. Many of them pull hair with the help of their fingers, some use tweezers.
Trichotillomania usually begins in adolescence and may last during the whole life. It is rare that the disease takes place after 20 years old. Violations can occur in children. This trichotillomania goes away when the period of puberty begins.
There are two types of patients with trichotillomania:
- People consider that trichotillomania is an important ritual. In most cases, the process is secret, thus loved ones know nothing about it. A person prepares for the procedure in a certain way: takes tweezers and creates a suitable environment.
- People pull their hair without realizing it. The process starts during a fascinating occupation or severe stress. Sometimes a person does not even know that he pulls hair: other people notice balding later on.
A person can pull hair in certain areas of the head. Some patients make hairline thin or do it diffusely. They hide the consequences of the disease using hats, different hairstyles, wigs, and so on.
Because of shame and cosmetic defects, social life and communication with loved ones suffer. They can not go out in windy weather, ride, exercise or dance – in all of these situations, others may notice balding.
Such people are depressed, they feel constant stress and increased anxiety. Trichotillomania is often accompanied by conditions such as:
- Alcohol addiction;
- Chronic depression;
- Drug addiction;
- Anorexia or bulimia;
- Mental disorders.
Some of the people with this disorder throw away pulled hair while others carry out various rituals with its participation. It may be a game with hair: rolling it into a ball, storing in a special container or even swallowing. In the latter case, over time, a large ball of hair occurs in a person’s stomach, which violates the digestion and requires surgical treatment.
The main external symptom is baldness of different sizes and shapes.
It is not always easy to make a diagnosis since the patient can hide the cause of his condition. The doctor asks the patient and his relatives in order to find out the time of the beginning and especially its course. Trichogramma (examination of hair roots under a microscope) is used in order to make a diagnosis as well.
Since there is no understanding of what leads to its occurrence, effective treatment of trichotillomania does not exist today. There are many different ways of treatment, many of which are useless. Here are only those that give positive results.
The treatment of the disease in children is carried out in the form of the game – it allows the child to speak openly about his anxiety and fears. Gradually, the baby gets rid of internal tensions and the habit of hair pulling may disappear. This therapy is effective only if trichotillomania for children is a way to escape from unpleasant thoughts.
Hypnosis is conducted by a psychotherapist. He inspires the patient that he experiences intense pain when pulling hair. Hypnosis helps to reduce the overall anxiety and get rid of the habit.
During this therapy, people are taught to replace a bad habit by other actions: in order to pull hair, a person must strain the forearm and make a fist. Such exercises can be carried out in any situation, over time trichotillomania will be cured. Various studies prove the effectiveness of behavioral psychotherapy.
Taking meds should be combined with psychotherapy – this combination is the most beneficial in getting rid of the disease. Trichotillomania treatment includes the following drugs:
- Selective serotonin reuptake inhibitors – they increase the concentration of endorphin and serotonin in the brain, which improve mood, eliminate anxiety and discomfort. Fluoxetine is used, the improvement occurs after a week of taking.
- Tricyclic antidepressants have an effect similar to the previous group of drugs but unlike them, they affect other endorphins: norepinephrine, dopamine.
Home treatment requires a lot of motivation. In order to treat trichotillomania, it is important to accept oneself. It is necessary to master relaxation techniques in order to get rid of anxiety. Yoga and meditation are perfect for it.
In addition, it is recommended to use herbal decoctions with sedative effects (motherwort) and take them three times a day.
In order to evaluate the effectiveness of therapy photographs before and after are used. Prevention of trichotillomania is not established since the cause of this disorder is unclear.