Trichotillomania consists of repetitive, uncontrollable pulling of one’s body hair. In most cases it is related to an increased stress level at home or school. Treatment involves self-monitoring of hair-pulling episodes as well as the feelings and situations that are most likely to lead to hair pulling. Children are then systematically taught a new behaviour, for example, squeezing a ball or tightening their fist that they are to do whenever they feel the urge to pull. From a dermatological standpoint, it is one of traumatic alopecia. Newly growing short hairs with tapered ends and broken short hairs are visible in this 12 year old girl. Trichogram may be needed for diagnosis in some cases.

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Bell Eapen
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About Bell Eapen 247 Articles
Techie Dermatologist, Information Systems PhD, Supporter of Open-Source Software, Machine Learning and AI geek, loves cricket, Canadian wine and beer. [Resume]


  1. This is definitely an over simplified way to explain trichotillomania. It isn’t just a matter of behavioral training in children. I’ve had this disorder since the age of 12. 18 years later, I still suffer from it. Some days the treatments work and some days they don’t.

    I remember back when my parents were trying to get a diagnosis for me, that they took me to the dermatologist. I told him flat out that I was pulling it out myself. He told me that if I didn’t stop, he would have to take a scalp sample to “scare” me out of it.

    Can I just tell you how damaging it is to hear your doctor say that to you when it is a disorder that you can’t control, don’t understand, and don’t even have a name for yet? Be careful what you say to people who might have trich! It’s a horrible disorder with so many layers of self confidence problems. Having a doctor just tell us to stop, or try to scare us out of it, isn’t constructive.

  2. Thank you very much for the critical comment. I completely agree with you and I believe understanding these disorders from the patient’s perspective is crucial in the management.

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