Trichotillomania

Trichotillomania (TTM) is a condition in which people feel an overpowering urge to pull out their hair.  The urges seem uncontrollable and are often exacerbated by stress or other emotional upsets. The term was coined by the French dermatologist François Henri Hallopeau in 1889.

 

People who suffer from TTM will pull, pluck, or twist their hair until it comes out. Others may use instruments to achieve this goal. Sufferers will pull hair from any part of their body: scalp, face, eyelashes, arms, legs, or sometimes a combination of these areas. However the scalp is the most common pulling site. Some people may also have the compulsion to eat the hair. Less common is unconscious (or sleep-induced) hair pulling, in which the person doesn't consciously realize he or she is doing it. Symptoms usually begin before the age of 17 and it is more often seen in women, but can inflict either sex.

 

Analogous to self-injury , the act of hair pulling is usually followed by a period of intense self-blame, shame and sometimes anger because the 'puller' knows that the behaviour is in some way self-damaging, yet they can feel helpless to stop.

How many people does it affect?

The true prevalence of TTM isn't exactly clear, since people are often ashamed of their behaviour and are subsequently reluctant to discuss it, even with their GP. So it is therefore difficult to get reliable statistics. Historically it was thought to be rare, but the condition is now better understood and more people are seeking help. Recent estimates range from 1 to 3.5% of the population, depending on the definition used.

 

Treatment

Behaviour Therapy approaches include several techniques. The most central of these is Functional Analysis, or identification of the antecedents (precipitating behaviours, events, emotions, sensory experiences), behaviours (when, where and how does pulling occur?), and consequences (what does the youth get out of pulling?) associated with pulling. Other behavioural techniques include Habit Reversal Training (HRT) which consists of developing an awareness of sensations preceding and during pulling behaviour through self-monitoring and related techniques and the use of competing responses or compensatory behaviours that are incongruous to pulling. Stimulus Control which focuses on reducing environmental or other circumstances that trigger pulling is often included as well. Relaxation and other anxiety-management strategies, cognitive restructuring of thoughts related to pulling and self-soothing, and strategies to enhance motivation for treatment compliance may also be utilized as part of a behavioural approach.

 

 

 

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