Advertisement

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.

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 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

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.

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.

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

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!

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

I’m still trying to figure out my exact diagnosis, but trich is about the closest I could come. I started by just plucking ingrown hairs with tweezers( I’m a very hairy guy)but I noticed I was doing it more often, and more on not just ingrown hair, but any hair that stuck out to me. I do it about 3 times a day almost every day, but if I can’t find anything to pluck I stop for a couple days. I pluck my chest, belly, pubic area, inner and outer thighs, shins, and calves. It’s only noticeable if you look, there’s a plethora of scabs and hair loss. It’s common for bleeding to happen and with how much of a routine it’s become I suspect it might be a form of ocd as well. I’ve been doing it for about a year now, my mom and dad don’t know, and my sister does but not how severe it’s gotten. I haven’t brought it up with my therapist because it’s embarrassing, but I’m going to soon. I really want to stop. My hair has always been a part of my body I was proud of, and it helps me feel masculine. But now I never show it off because I’m covered in scabs and half-leg bald patches. Reading all your stories of feeling ashamed and weird, or being teased by your friends made me realize how important it is that we confide in each other. I know, professional or not, telling people is scary, but eventually someone will hear you and take you seriously. (If anyone thinks what I have isn’t trich I’d love to hear about it, because I’m lost in the big bad world of mental illness mystery.)

Hi - I too do this but am older. Is there someone you can talk to, your parents or someone at school, who could help? I'm sure they'd want to if you told them. It's not your fault you have this.

Hi..
Even I am suffering from trichotillomania since 3 yrs...I am now damn frustrated with it.
This thing is not letting me concentrate on my studies.
I feel like crying that why it is happening with me.
How to stop it?
I am getting bald day by day.
I dont knw what should I do.
Is it a mental illness ? How it can be cured?

I have 33 years old going through the same thing. I am holding the phone with one hand reading all the comments and the other hand is pulling hair out my scalp. I can’t seem to stop. I am lucky the hair grows back but I can’t help but pull at the regrowth. Why does it feel good. I get get so lost in the process and by the time I stop pulling half my head is bald.i just want to be normal🤔

Thank you so much for this article. I have lived with Trich for a very long time & it took me most of that to know I knew it was a condition & a condition that I could talk to someone about.
Reading your article gave me a peace with Trich that I've not had before.
I guess you could say I'm doing really well at the moment & the patches I had have fully grown back, so that's really a big deal.
I do find I'm have to catch myself before I'm about to pull but I'm winning & it's nice that my scalp isn't sore. I did have my hair cut really short around the back & sides so that has helped too, but I know not everybody wants to have short hair but maybe someone reading might consider it if they think it might help?
I want to again THANK the author, even after 25 years of having Trichollicomania your article has helped me.

Best Regards

Cheryl

Hi Cheryl, thank you for the wonderful comment on my article. I'm so glad that it helped you, even after living with trich for such a long time. I wish you the best in your journey!

I’m 13 and I’ve been plucking my eyebrows and eyelashes for years. My family were so disappointed when I plucked off all my eyebrows as I used to be beautiful. I just wish they’d understand taht I can’t stop I wish I could because I really want to. After I pluck I feel so sad and disappointed in myself I just don’t know what to do anymore. My friends are so supportive but no one really gets it. I’m afraid to get help as I don’t know how and I’m ashamed plus I bet it’s be expensive and my dad wouldn’t believe taht I actually hav a true problem. I just wish there was a way to stop I just look at myself in the mirror and feel so upset

You may not feel like it right now, Anni, but you are still beautiful! I'm so happy to have found this thread with your brave words because my little boy has started doing this, and no amount of baldness will ever affect how beautiful he is to me. You say you're worried about telling your dad, but a good first step might be to talk to a counselor at school. They may be able to offer you some tips or tools to deal with anxiety, plus it can be really helpful to just talk to someone sometimes! This is what I'm hoping will help my son, too.

I've been pulling my eyebrow out since my dad died in 1989 I'm 61 years old now and I tend to pull my eyebrows out daily I have severe anxiety I've been to mental health I still can't control.it

Nobody in particular

November 9, 2019

I've been pulling every type of hair on my body for six years and I'm currently 13. I have zero eyebrows and eyelashes and cover it up with eyeliner (I have nothing else to use because my parents don't like makeup). I'm always being told to 'just rub it off'. I hide my eyeliner pencil and my parents have threatened me to go through everything in my room if I don't tell them where it is. I am also always being asked 'just stop pulling' everyday in the car, at home, during dinner, when I'm doing my homework. In other words, every moment I see my parents. Because of this, I hide in my room whenever I can. I don't want to face my parents. When I do have to see my parents, I always see them looking not into my eyes, but at my eyebrows that have been drawn on. My mum, especially, is bad at hiding her emotions, so she always has this look on her face as if she is disgusted and also pitying about my eyebrows. Her eyes are always darting around when 'looking at me' so it is completely obvious that she really isn't looking into my eyes. This makes me extremely irritable. Now, I have severe depression and anxiety about this topic. I want to die, and I cut myself when I get really angry. I think I've gone a bit crazy too because I like the blood that comes out. I crush my hopes and passions like bugs and feel empty. I don't know what I'm meant to do anymore.

I constantly pluck my eyebrows and arm hair out. i sometimes pull the hair on the back of my head out. I just thought it was related to stress but recently i have been thinking about it much more often to the point if i dont get a certain hair out i cant relax and sometimes i dig to try to get it out. im not sure

I have been suffering from Trich since the first grade. It started with my eyelashes. I would do thus routine everyday where i would get all of the eyebugers out of my eyelashes, and then one day i pulled one out. I did that stupid thing that our parents do, thumb or finger. I made a wish, and u got it right. I kept doing it. My best friend died around that time, I can't remember if it was before or after. I pulled my eyes bald soon. When my mom found out she dint understand. She told to just stop, it shouldnt be that hard. I couldn't stop. Then one day, she caught me in the act and just had a full out screaming fit about how I am always living in the dark and can't see any good, the while thing. I will remember that day forever. In coming years, I went to several different therapists, none of them making much of a difference. Some time in 3rd grade I had eylashes for a month maybe. Over time, i started pulling from other areas too. Then bald until March, this year. One of the only reasons I was able to have some lashes back was because I found a friend who also has trich. It helped me alot, having someone to talk to. The other reason, was thar I bought this candy that I really like that I rarely get, and then once a week, I would get a little if I hadn't pulled, or at least minimal pulling. Now, I still have my lashes, but they are so thinned out I am terrified I will have to start over. Whenever I get the urge I try to pull out leg hairs, but then i end up waisting so much time microscanning my legs for any ingrown hairs and such. I am a girl, so that goes to my benifit that my legs are supposed to be bald. If anyone wants to talk, you can email me at teheha14@gmail.com it was really nice reading all of your stories. Knowing that there is a healthy population of us out there, is comforting. Thank you.

Advertisement