Health Scan: Getting a handle on hair pulling
The phenomenon of pulling out one’s own hair has been classified by psychiatrists as an impulse-control disorder.
Young woman with hands on head (illustrative) Photo: Thinkstock/Imagebank
The phenomenon of pulling out one’s own hair – known by psychiatrists and
psychologists as trichotillomania – has been recognized for centuries but has
not been widely studied. Thus, how common the phenomenon is, exactly what causes
it and how to treat it are not well known. According to an article by
researchers at the Be’er Ya’acov Mental Health Center in a recent issue of
Israel Medical Association Journal (IMAJ), trichotillomania is referred to in
Homer’s Iliad, in William Shakespeare’s plays and in a work by Hippocrates. The
phenomenon of trichophagia – eating one’s hair – was mentioned even before
trichotillomania. The name of the condition was given in 1889 by a French
As bald patches can also be the result of diseases of the
scalp, such as tinea capitis and alopecia areata, dermatologists may treat the
loss of hair even though the cause is actually a psychological problem, Dr.
Moshe Kotler and others wrote. There are three types: early-onset (which affects
young children under the age of eight), automatic (hair-pulling when engaged in
other activities such as watching TV or reading) and focused (thought to occupy
the individual’s attention and associated with intense urges and
The condition affects women and girls more than men and boys,
probably because most females have longer hair but perhaps for other reasons as
well. Sufferers commonly deny that they have a problem and try to hide it. As it
has been classified by psychiatrists as an impulse-control disorder, medications
used for obsessive- compulsive problems are often prescribed, but studies of
patients who have taken these drugs have had mixed results.
noted that the condition has similarities with addictive disorders because of
the sufferers’ diminished self-control. Drugs usually given to help people stop
smoking by overcoming nicotine addiction have shown promise in at least one
study. Others have suggested mood stabilizers and food supplements for the
condition. The Be’er Ya’acov researchers said that genetic factors appear to
contribute to the development of trichotillomania, as it is more common among
identical twins than in fraternal twins who don’t share the same
Professionals have not been highly successful in treating
hair-pulling, and the condition is apparently more common and complex than
previously believed. The authors found that cognitive behavioral therapy seems
to be the treatment of choice, combined with certain medications.
more research into the disorder is clearly necessary.