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.

Hair Pulling- Trichotillomania

Most of us love hair. Hair is associated with beauty, youth and vivacity. The more hair we have, the better we feel. But there are some individuals who are so emotionally tormented that they pull their hair. Known as Trichotillomania, this emotional disorder induces an irresistible urge to pull out one’s own hair. While in most cases it is pulling out hair from the scalp, some may even pull the hair out of their eyebrows, groin and extremities. Hair pulling from the scalp is readily visible and some individuals go to great lengths to disguise this behavior.

Trichotillomania is more of an impulse control disorder rather and an obsessive or compulsive disorder. Individuals who have this disorder simply can’t resist the urge to perform an act that is harmful. While hair pulling is usually done with the fingers, it may occasionally be removed with instruments like razors, blades, combs, brushes or tweezers.

For some individuals the hair pulling is intentional and focused. They are aware of what they are doing, but for other individuals, hair pulling is an automatic event and they may not be aware of it.

The cause of this bizarre condition is not fully understood. Scientists have identified mutations in some brain neurons that may trigger the urge to pull out hair. In others, changes in the neurotransmitter serotonin and dopamine have been identified. But these discoveries are academic and have not helped treatment.

It is estimated that about 1-3 percent of the population may have some degree of trichotillomania. The disorder can affect both adults and children and may be seen as early as age 2-3. Why people pull hair is puzzling. Some individuals pull the hair out because the hairs may not be of a particular color, texture or shape. Others develop delusional thinking that certain color hairs are bad. Sometime hair pulling is done during a mood disorder like anger, frustration or tension. Other individuals pull their hair when they are lonely. There are individuals who find that that pulling hair makes them feel good and they continually try to seek that kind of positive reinforcement. Others claim that when they pull hair, it is way of distracting them from negative thoughts, stress or tension.

Even more puzzling is that these individuals almost never pull other people’s hair.