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by Aarti Gupta, PsyD
trichotillomania

I recently discovered that two friends of mine suffer from trichotillomania, or compulsive hairpulling. It came as a surprise to me, and even as a clinical psychologist, it was difficult to detect because neither one of them pulls out their hair in an obvious manner. Although about 3 percent of the U.S. population experiences trichotillomania during their lifetime, few people know what it is — and even fewer want to talk about it, which adds to the elusiveness of this disorder.

Trichotillomania (pronounced trick-uh-till-uh-may-nia), often called trich, is characterized by an uncontrollable urge to pull out one’s hair — from the scalp, eyebrows, eyelashes, or other areas of the body — to neutralize an anxious feeling. If the hairpulling is severe enough, it can leave bald patches, which my clients often describe as embarrassing, isolating, and frustrating.

Hairpulling can take place unconsciously or consciously due to boredom, stress, anticipatory anxiety, zoning out, and other circumstances. After pulling out hair, my clients may even report feeling relief or satisfaction as they describe having “scratched an itch” or “pulled out a hair that didn’t belong.” Family and friends can find it perplexing that a loved one could find this habit pleasurable. Indeed, it could be a sign the person may be dealing with unresolved anxiety or an inability to cope with stress in a productive way. But sometimes no defined reason can explain the behavior.

If you or someone you know suffers from trich, the best bet is to find a licensed psychologist who is trained in cognitive-behavioral therapy (CBT) and habit reversal training to help manage symptoms. In the meantime, I’ve compiled a list of questions NOT to ask the person suffering from trich because these can often do more damage than good.

What Not to Do

1.  Don’t ask, “Why don’t you just stop?”

Chances are, the person already asks themselves this question every day. This diagnosis can carry a lot of shame, and this statement assumes it is easy to stop pulling. If someone could stop, they would.

2.  Don’t suggest, “Stop covering your bald spots so you can actually see the damage.”

Covering up is controversial. While some clients find it freeing to take off their makeup and wigs, others find it shameful and embarrassing, and they can regress to feeling hopeless, helpless, and far from their goals of stopping the behavior. Until you know how someone will react to this strategy, skip this advice.

3.  Don’t say, “You need to learn to relax, and maybe the pulling will stop automatically.”

Usually, this isn’t true. My clients with trich have hairpulling on their mind constantly (which can be mentally exhausting) and have uncontrollable urges to pull. These urges typically require much more than just relaxation to reverse themselves, so don’t assume it’s that easy.

4.  Don’t carefully observe the person and signal or say something when they are pulling...

…unless the person asks you to do this. Many people feel watched and judged with this technique, so ask them if verbal notice would help before becoming the “pulling police.”


About the Author

Aarti-Gupta,PsyD-websize.jpgDr. Aarti Gupta specializes in CBT for anxiety and related disorders, as well as body-focused repetitive disorders such trichotillomania. She is Clinical Director at TherapyNest, A Center for Anxiety and Family Therapy in Los Altos, California.  

Other resources:

What Is… Trichotillomania? Causes, Treatments, and Resources

ive suffered from trichotillomania since i was a young child. the thing that had helped me the most i think is the support ive received from the people who love me. maybe just remind her youre there for her and you love her. but on the other hand, everyone is different and has different ways to cope and not pull. i also don’t known your guys’ relationship so im unsure of how often you tell her you support her. but yeah,, its a good idea to let her know youre there for her and you love her. even if it doesnt help it sure makes you feel good to know someone cares.

My fiancé is trying to help me through my mania. We made a deal last night because I want him to stop smoking cigarettes. So he came up with this deal that if I stop pulling my hairs out of my eyelid and eyebrows, he will stop smoking. It’s helping me because I’ve attempted to pull all day and thinking of how he is supporting me and not judging me in this condition I have, and instead is trying to help me, he motivates me to eliminate this embarrassing condition. Plus it’s helping him to stop smoking. I’m hoping it will go on for the rest of my life so I can see how beautiful I really am.

I have done this since I was 7. I don't know exactly what or even why it started happening and chances are your friend doesn't understand it either. Shaming is the worst, I have even learnt to apply false lashes to help hide it. Being there and not judging your friend is the best thing you can do.

Hey just wanted to let you know that you’re not alone & I’ve been told the exact same by my parents. I too struggle with trichotillomania as I started pulling at a young age that started with my eyebrows to my eyelashes & my scalp. Over the years I’ve made an improvement from the urge to pull my eyelashes & eyebrows but as of today I am still trying to cope with an effective way to prevent myself from my pulling disorder... not easy but it’s a relieved feeling to know that we are not alone in this.

I suffer from trichotillomania and my loved ones laugh because i have no eyebrows but i used to not do that unyil almost 4 yrs ago i lost my daugther at 1mo & 2 days old and i realized it affected me more than i thought until i just stopped to think i held my grief in for so long as started pulling at my eyelashes and eyebrows to cope i still do it till this day and i dont know what to do or how to stop it

That's awful, I'm sorry for your loss. Maybe you could try pulling from somewhere else, I'm not putting my name so I feel okay in saying that I pull from my pubic area on my vag. At least that way your family won't see it.
I don't know why, I have no real reason to but I can't stop and I feel like it's never finished because it certainly isn't. I dig into my skin with tweezers to get ingrown hairs or even hairs that haven't broken the surface yet. I pull any hairs that look too dark or prominent at first and then I get the rest in whatever order I want. Needless to say, it is not as pretty as it used to be, but I'm afraid to let it grow out and heal over cause it'll be gross. There's little scabs and uneven redness and ingrowns(before I pull them) all over where I pull from. It's annoying but when I see one that doesn't belong I feel like I have to remove it from my body or I will be impure and ugly even though nobody else can see there besides my boyfriend, who says I should just shave because it looks painful to him. Sometimes I lock the door so he won't see because even with him I am still a little embarrassed about it. Should I just stop, can I just stop? I haven't tried to stop ever before. That's pretty much my whole story thing. I used to only tweeze my bikini line until about 4 months ago and I just started ripping away relentlessly and some of them hurt more than others but after they were out and gone it looked like no hair had ever grow there but now it looks like I tear my skin apart because I do. Maybe someone could offer me some advice as well.

I, too, lost a child. My son, it's been 6 years and I still pull and have NO eyebrows!! I also pull if there is a hair on my leg I missed shaving. I can't stop. My husband constantly says, stop picking!! Nobody understands how bad I wanna stop

I have pulled my hair out since I was 13 at 13 I was very badly bullied at school then at 14 I lost my bestfriend to epilepsy which I've suffered with since 3 years old then at 15 I lost my nan who I was extremely close too then at 18 i lost a friend I've grown up with then at 19 I recently lost my cat I've always pulled my hair since I was 13 at school getting bullied til now and I can't help it my parents tell me to just stop but it's not that easy I don't even realise I'm doing it sometimes I've only recently thought about going to the doctors about it because I used to have very nice long hair but now it's like a patchy bald mess and it makes me feel very insecure

I’m so sorry to hear of all the trauma you have endured in your short life. No wonder you’ve been pulling! Instead of going to an insensitive medical doctor to address the hair issue, I would suggest some counseling. There’s free and low cost counseling almost everywhere. Look up something called The YWCA. I went through a lot of trauma growing up and into adulthood and I started constantly pulling. I wound up buzzing all of my hair off and you know what? It was the moat freeing day since I started pulling. If there’s no hair there, there’s nothing I can pull. I put growth oils on my scalp everyday and eventually the patch went away and my curls are thicker and healthier than ever because of that buzzcut. I wish you all the best my dear.

I never used to even have the thought of pulling hair out until I started wearing makeup my sophomore year of high school! I would always wear mascara and it would clump up. The clumping would get annoying and that’s when I would pull out the clumps, that led to a couple eyelashes being plucked out, it hurt at first but then I got used to it and it steadily started to become a habit. About a few months later I started to wander my hands on my scalp, it would be frizzy for this damp Texas weather in the mornings and I would start pulling hairs from the back of my scalp, it wasn’t that bad until i entered college. I tend to stress out bad and pulling hair would relieve my stress until I looked the mirror and saw the damage I had done to my eyelashes, my scalp hair during my freshman year wasn’t so bad but I’m still in college, I’ve gotten better at not pulling my lashes and they were fully grown and thick and I was proud, for the longest I stopped pulling both head and eyelashes was about 3 months but when something comes it, it starts all over again, it’s a never ending battle and it sucks so bad! I’m glad my parents don’t judge me too much but I’m thankful for the things they tell me to help me stop, my mom doesn’t understand why I do what I do but my dad does cuz he had a very small case of trich. I think I learned it from him subconsciously cuz every time he thinks, he rubs and tugs at his mustache a little. Anyways, I pray that we find a way to cope with this or find a substitute to stop this hair pulling, I wish we could just tell our brains to stop but prayer is strong enough to end this bad habit

i have that said to me all the time. im not sure why but it makes it much worse. I wont stop ill just try not to do it in that person's presence. I hope that all gets better for you. Im truly sorry for your loss

I am so very sorry for your loss. I lost a baby boy at 3 months old. He was very sick. I started pulling my ir and ye lashes out many yrs ago. As a teenager. I am 61 and now and then when I am stressed I think is when I tend to do it. Time will heal your pain. The Lord was a great help to me.

I'm so sorry for the loss of your baby, it happened also to a very close friend so I really do understand. I also live with Trich, which I'm only learning of the 'nick name' this evening. I've lived with it for a long time & didn't know to talk to someone & get help, so that's what I would say is if you can go & talk to your Dr. to get some support & talk to someone who will do just that & support you, not laugh at you.
I hope something you've read on here has helped you in some way.
It can get better for you, don't struggle alone.
Cheryl

I wish I could comment that this condition will eventually resolve on its own, however, that's not the case. I am very, very embarrassed that this disorder started when I was over 50 years old! After several severe losses and prolong stress, anxiety, depression, I began tweezing hair from my legs - and I can't stop. I am over 65 now and the compulsion is incessant. I am so embarrassed and must use dermablend in public if any part of my legs will be visible. I have spent thousands of dollars on creams and serums in the hopes of fading the ugly scars. I understand certain new cosmetic procedures MAY reduce the scars severity on my legs, but I'm too embarrassed to seek this out. Just wanted to put this out there that this is not only a young person's disease. I am just miserable - yet still compulsed.

I’m so sorry about your loss. I started pulling when my cousin passed away. It’s been 10 years and I still pull my eyebrows. Although I can’t find a cure, I’ve found products that really help grow my brows and lashes. There’s a website called Forchics and they have products called forbrow and forlash that you apply before bed.

I have suffered from trichotillomania for around 7 years since I was 7 and I have always let them grow by themselves which is a long and tedious process and it also has made me worried that they wont grow back but now you have suggested this I am definitely going to try it

my Parents never told me this was an actual disorder and I have been pulling my hair out since I was 8 years old and I’m 19 now. I’ve felt so alone and could never explain why I do what I do and I can’t ever wear my hair down I have to wear it up in a ponytail because it hides my bald spots. People would always call me a slob in school because I wouldn’t ever wear my hair down or look nice because there was no way I could and look normal. And throughout this I've felt alone and so weird. Just today I learned I’m not, other men and women go through this and I’m not weird.

i am 14 years old i actually pull my eye brow hair most death love pulling my knuckle hair hairs every were the lest place i pull is my real hair trying to let it grow out actually but yea i am very young and i dont even stress it just feels so good to me it satisfies me .

I’ve suffered for 2 years now. I feel so helpless, but found a couple of things that have helped me.
Whenever you find yourself picking, cover your finger, and calm down. The reason why you might be pulling is probably stress. Also, put a hat on if you pull your hair. There is this bracelet that can tell you when you start pulling. Search up Keen Trichotillomania Bracelet. Find a plan and keep your mind to that plan. Don’t feel bad when you pull. You can’t be perfect. Also remember the phrase: Your in now, not yesterday. That means that if you pull, you shouldn’t spend your time regretting it because you can’t fix what you did. Focus on now. Good luck.

i feel that i am suffering from trichotillomania and my parents and friends tell me it’s disgusting and that i should just stop doing it but i cant

I started my condition in the 3rd or 4th grade. My mom use to whoop me for my condition to try and get me to stop, and at the time we didn’t know what it was, but common sense should’ve told my mom something had to be mentally wrong. Family members yelled at me for it. My family members thought I had cancer, which I don’t know how and they had me believing that I could develop cancer from picking at my hairs. I don’t do it on my head. Just my eyelids and eyebrows. I have a fiancé who is trying to help me through this and I love him for supporting me. He made a deal with me because I want him to stop smoking cigarettes. He said that if I stop pulling, he will stop smoking cigarettes. That deal motivated me. I slipped and pulled two hairs out not too long ago but I’ve done better than I did days before today because I would pick all day. Things take time and I am patient. What motivates me is my fiancé, seeing pics of beautiful women, or seeing pics I’ve taken with filters that gave me eyebrows and eyelashes. Another thing I do is redirect myself by watching tv or playing the game because I’m a game freak. I still get great compliments on my facial appearance but I could look better with my hairs. That’s what motivates me. And cameras/mirrors give you different images so I barely like to look in them.

So I have trichotillomania and i have resorted to trying my hardest to cover it up but its hard and before when my parents knew I still struggled with it they didn't understand. Will it always be this hard not to yank out all my eyelashes, or to not pull my eyebrow hairs?

Last night I pulled out every single strand of my lashes one by on, and the whole Time I was thinking to my self, “why am I so weird” “nobody is ever going to love somebody like me” and “just stop pulling” by the time I was done over thinking they were all gone. Now I’m laying in my bed at 2:05 pm crying, and depressed because I look like a freaking idiot sitting here bald eye’d. Embarrassed to even look in the mirror, I don’t want to go outside, I’m even considering quitting my job. Sometimes I think the best solution is to commit myself but I don’t want to be medicated, and suicide just isn’t an option for me anymore because I couldn’t imagine leaving my child to grow up without me. I JUST WANT THIS TO STOP!

I do the same thing. I try to stop so hard but it’s almost irresistible. A tip would be to find out from where it stems, is it self hate, etc. as soon as you find that out it gets a little easier. Also find out when and where you do it and put yourself in the opposite situations, but just remember that you can do all things through Christ so it’s not impossible.

I have suffered from the age of 4, I am now 27. I have not had eyelashes since the second grade and after being in at EF5 tornado and surviving, I have not had eyebrows since 2011. I utilize strip eyelashes and put them on every morning with glue. I can make a single pair last me 6 months and cake them up with mascara. I partake in microblading for my eyebrows that way people do not know I do not actually have eyebrows. If you need someone to help you or to follow so you don't feel so alone- Add me on Iinstagram @ jessiemcnally22. Lets be eachother's support. When you add me, send me a message that says #metoo so I can know who my fellow strugglers are. Lets do this toegther. We may not be able to beat it, but we don't have to go at it alone either. XOXO

I feel you. I just pulled out all of my eyelashes, and now I’m laying in bed crying again, for the 1,734th time. I’ve been so good this last year; I recently moved to Florida so I’m always in the water and didn’t want my new friends and bf to see me like I used to be, I actually had a full set of lashes for once in my life and was so proud to put on my mascara for once and not be asked “why are you wearing false eyelashes?”
I’ve pulled since 4th grade. I saw my mom doing it, and I think that’s what started it. We always said it’s because of stress. I do find myself doing it when I’m not even paying attention and not stressing about anything at all. But the moment it really happens and I notice what’s going on inside me I realize i May have bottled up feelings for a long time and now I’m coping with them.
When i was little I had crazy long thick lashes, now I just feel like I look sick and I want everyone to just leave me alone and act like I’m not here so I can not worry any more than I have to if they see me without false ones on.

I wish you the best, and I hope we don’t let ourself a think down the wrong path anymore. We have support and we can get through this!

I do the same fricken thing. I pull my eyelashes out until I have a mental breakdown and want to cry all night. If you talk to others about it, that really helps. I hate looking in the mirror after I just pulled. It makes me so sad and feel scared about what other ppl think. I get it.

I also suffer from this as well as dermatillomania. In fact, I just learned what picking my skin is called. I googled trichotillomania; and, I saw a link for Keen trichotillomania bracelet. I am going to look more into this. Good luck to everyone who suffers from BFRB. Hope this helps.

What makes things worse is that all of my family are skin doctors. They've done all of these, and have compared me to various bald mythological characters. It makes me laugh at first, but honestly, I'm just trying to find a way to cover everything up and not do too much damage to myself. I want to live a healthy life. I'm still really young, and every time my family mentions this issue, I feel like I've aged by a decade. When I was in second grade, they paid my best friends to slap my hands whenever I pulled. When I was in fifth grade, they asked me whether or not my friends have gotten disgusted and have left me yet. My dad has suggested multiple times that if I can't do things well, I should go kill myself. Nothing really related to trich, but it made me want to cry every time he said that, especially since I knew he cared and that he only said it as a strategy for me to not actually do it. But I have noticed that before he'd started saying it, I had been more hopeful about my general view of life. I don't think I'm depressed. At least I would like to think I'm not? I mean, I don't know. I can't seem to do anything right. My head feels like it's full of trash and oil, and I feel like sometimes it makes my hair grow weird. So I just fumble around and grab the strands that curl weirdly. I just want to cry right now. I have no idea whether or not it's related to events in my everyday life, but whenever I do something, I'm doing it wrong and I want to cry but I don't. The three times I've been out of the house, it hadn't been my choice. I was chased out of the house. I didn't run. Once, it was after my dad had said it could've been much worse. That he could've hit my back with the stick like the ancient Chinese prisoners and broken it instead of my thighs, where there was protection from the thicker tissue layers. And before that, there was a blurry memory I didn't remember well because I'd been crying, but I'd yelled back, and he'd grabbed a knife from the kitchen. I knew he would've never. And he didn't. He threw my brother's boots instead. And yet I'm compared to my cousin, who's now twenty something and has never graduated high school. Heck, I'm called a poorer version of my cousin, because her dad had more money. I have good grades. I do very well in things I'm interested in. I dedicate a lot to things that catch my interest. I finished costumes for the musical in a matter of days, I've worked on my singing and my cosplays and my dresses until three in the morning, and I plan special events to the smallest detail. It's just the things that don't that I fail to try hard in. It's like I'm relying purely on luck to get pass my everyday life, and I don't know what I want anymore. Is this a rant? I don't know. I want to talk to someone, but it's so hard. I feel like there's really no one there I can talk to. Going to school counselors and therapists means confirming to my dad that I have mental problems, and I would feel disgusted by myself for letting him believe that. Speaking to my family would result in more scorn. They already hate my face enough as it is. Speaking to my friends would be awkward and vaguely attention-seeking, seeing as they have their own problems. Speaking to myself, I don't like. My mind comes up with so many worse scenarios each time I think. I don't want to die. I don't want to be depressed. I don't want to pull my hair. I just want to talk to someone that I won't have to hide my face to whenever I cry and won't ridicule me or have their own problems or pull in a college intern student into the room to observe their work while I speak. I want to talk to someone strong who won't pull me down or let them be pull them down with me. That's all.

Dear Rant,
Going to all this and still standing shows wat a strong character you are. Your grades at school will soon bring you to a new world with all the love and friendship you derserve. It appears that your father can't cope with the situation. That is not your fault. It's totally his responsibility and misfortune. Unluckily you suffer the consequences. But don't ever think that this is normal or that you deserve to be treated like this. A good idea to share you thoughts here. All the best to you. Xx

Dear rant, you need to get away from your father. He tells you, if you can’t do anything right ,just kill yourself. That is no loving father. Try to find someone who supports you and get away from that terrible man, that sais he’s a father. I think your hair pulling will improve with a person who shows you love. . Good luck

I want you to know you can talk to me if you ever feel alone. No judgement. Just a friend to listen. My wife suffers with trich and I was on here looking to understand more. Reading what you said hit me hard. I want you to know that as hard as it may be to admit this, your father is extremely abusive and might be the whole reason you struggle. Although there’s usually a lot of reasons. It sounds like you love your father very much but that he struggles A LOT with being understanding and supportive to you, not to mention extremely violent. Here’s my email rawaloha87@gmail.com please don’t feel alone, I care about you, even though I don’t know you, just reading what you wrote I can tell you have a good heart. If you need anything or just someone to vent to, please know you can reach out any time. Much love to you in this difficult time.

Your Dad sounds like the one with the problem, and perhaps the motivation for your habit? You are beautiful. With or without hair. 1 Peter 3:3&4 "3Your beauty should not come from outward adornment, such as elaborate hairstyles and the wearing of gold jewelry or fine clothes. 4Rather, it should be that of your inner self, the unfading beauty of a gentle and quiet spirit, which is of great worth in God’s sight."
I struggle with trich also. They called me no eyelash girl in elementary school. I pray for God to make me stop. I have been able to keep my eyelashes for some time, but when I'm under more stress than usual, it comes back. I just pulled out most of them on my right eye, for the first time in a long time. Maybe it was to encourage you. I decided to look it up, and here you are. The first time learning about this community at all. I love you. Don't believe the lies. When other people are insecure, you remember what I said, and be grounded & rooted in faith, in knowing God's love and approval for you. Carry on with your head held high. You are of great worth.

You are the first person online that I have found who was also terrorized by a parent for this. I'm adopted and have had trich for 44 of my 49 years. I was always beaten as a child for this (randomly -they would just pick a day for it and the beatings would come). When I was 12 (two months away from 13 -girl) I was feverishly studying for an event I was in the next day when my dad busted open my door (my mom was behind him) he tore off his belt started hitting my desk with it -said he would hit me 10x for every hair until my skin ripped open and would bleed (all while saying "look at me look at me"). Then said he was going to keep it in my room for me to look at. He would hit my brother with this so I was a mess. He has threatened me a few other times and I am permanently damaged. I managed to have a career and such but I am truly a disaster. I am so jealous of all of these kids today who have such supportive parents. No one cares what I have endured and I am forever a scarred person with terrible PTSD over this. I am sorry for your pain...and am sorry to put this out there but no one cares and I need to say it.

Hey, how are you doing? If you want to talk about things my Instagram is Jeyemey00, feel free to message or not. A lot of us feel alone and misunderstood but I like to believe that talking to the people that also have it is a start.

Hi I would like to say you are not alone I pulled out my eyelashes and my mum would call me a budgie and other things but budgie being the most prominent one this caused me to feel self conscious about myself and I developed anxiety and depression please take care and I hope that you flourish and thrive 😀

Hi
I’ll straight away get to the point. I am 24 years old, and i ve the habit of pulling my hair so badly that i can see the baldness in my scalp. Can anyone suggest me any product to regrow my hair?
Ps the urge to pull out, somehow i can manage but i just want to regrow my hair.

I am not sure about something to regrow your hair but there are hair fibers that do a great job covering up spots. They are called “Toppik.” Sally beauty salon carries them. I think eBay might have them too for even cheaper.

i ended up almost pulling out all of my eyebrow hair and i feel so ashamed and disgusted in myself and i look like a freak. i don’t know how to stop doing it though. i’m too scared to tell my mom about it cause i don’t want her to laugh at me and i don’t think she’ll understand so i’ve been filling them in but it’s only getting worse. this is the first time i’ve almost lost my eyebrows completely and i’m slightly freaking out. if anyone can help me with some tips to lessen the urge i’d greatly appreciate it.

I suffered with trich when I was 12 yrs old and although it was many years ago, I completely understand how you are feeling.
(I pulled my eyebrows out and was bullied at school.)
I think you should try talking to your mother about it, and explain how awful it’s making you feel both mentally and physically. I’m sure your mother loves you, and will want to support you any way she can.
If you just can’t begin the discussion with her, reach out to a school counselor, teacher, or another adult you trust, and explain what you’re struggling with. They can also help find a good therapist for you to speak with who can guide you, and offer expert advice. You are not a freak, and you are NOT alone. There are people who care, and who want to help you. It’s nothing to be ashamed of.

Please reach out to someone, so you can get the help you need. You shouldn’t be trying to deal with this on your own. A therapist can show you better ways to cope with your anxiety, and help make sense of what is happening. Many of them offer services on a sliding scale, if financial help is needed.

You deserve to feel better! This is a hard chapter in your life, but you will get through it!
Please take care of yourself! You can do it!

B, I just did the same thing, the day before Thanksgiving. Ahh! This hasn't ever happened before! I guess I just had two attacks within a week, and I took out the underside of my eyebrows first and then the fat part closest to my nose.
I feel and look so bald and gross, like I have so much forehead. At least my Mom isn't home right now, because she's the one who gets on my case about pulling.

Hi I use to suffer from this hair pulling disorder when I was younger and now I have more lashes in my left eye than my right because I use to pull my right side out I have one row of lashes in my right eye and it is so noticeable I don’t even like for people to look at me it’s terrible

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