Why does one pull their hair out? (Trichotillomania)

Hair pulling or Trichotillomania is a complex disorder and no one really knows why the individual pulls his or her hair. There are some risk factors which have been linked to this disturbing disorder and include:

Family history. There is a tendency for Trichotillomania to run in families. If there is a family member, either parent or sibling who has engaged in this behavior, chances are that or you may be affected. The chances of another family member developing same problem are about 5-25 percent.

Age: Trichotillomania usually first develops just after puberty and unfortunately in some cases, is life long. Children as young as 5-6 have been known to pull their hair. In such cases, it is not know if this is a case of temper tantrum or other behavior related problem. In children and teenagers less than age 16, the most common triggering factors are stress, the home environment, and school life. Common stressors in these individuals, which induce hair pulling, are changing school, divorce, death of a parent, constant moving and hormonal changes. It is commonly observed that younger children often pull their hair during bedtime or eating. Teenagers pull their hair in the daytime, most commonly in their bedroom, bathroom or in some secret location.

Gender: From medical follow-ups, it appears that women are more affected. However, these numbers have a treatment bias, as more women tend to seek help. Most men hide this problem and feel embarrassed to seek help. Overall, it appears that both genders are equally affected by Trichotillomania.

Feature of Hair: A few individuals pull out their hair because of a body image distortion. They simply do not like their hair. Some individuals do not like the color, others do not like the style and yet others hate the texture.

Emotions: The great majority of individuals who pull their hair out have emotional problems. Many of these individuals deal with their negative emotions (stress, anxiety, fatigue, loneliness, tension) by pulling out their hair. Estimates indicate that at least 40-70 percent of individuals who have Trichotillomania also have other mental disorder like depression, bipolar disorder, obsessive-compulsive disorder or some type of eating disorder (bulimia, anorexia)

Reinforcement: Some individuals find that after pulling the hair, they feel better. These individuals often pull the hairs and hold it close to their skin, which gives them a good feeling. Unfortunately, this creates a positive reinforcement and leads to a cycle of hair pulling.

Unfortunately, even when these risk factors are identified, treatment is difficult and relapses are common.