What is trichotillomania (trichotillosis)?
Trichotillomania, or trichotillosis as it is now more commonly called, is hair loss caused by rubbing or pulling of the hair over long periods. Chronic cases can lead to scarring (cicatricial) alopecia, where the hair loss is accompanied by scarring of the scalp. Scarring can cause permanent damage to the hair follicles, and so no regrowth of hair growth may be possible in the affected areas. The condition can also result in feelings of low self-esteem in the sufferer.
What causes it?
Trichotillosis is a self-inflicted condition that arises from repeated pulling, twisting or rubbing of strands of hair. It may occur simply out of habit, or compulsion, or it may be a manifestation that the person is on the obsessive compulsive disorder spectrum.
It can also be a symptom of stress or anxiety or even a result of self-harm. It often occurs at times when the sufferer is not focused on their actions, for example when they are distracted watching television.
It is also worth considering the presence of head lice as a reason why children are often touching their hair.
Symptoms or signs
In trichotillosis areas of hair loss are often irregular and angular. These areas are also punctuated by twisted, fragmented hairs broken at various distances from the scalp. In addition, eyebrows and eyelashes may also be involved. If the condition persists, then scarring on the scalp may result which prevents regrowth occurring in the affected area.
Why see a trichologist?
A trichologist will be able to make or confirm a diagnosis of trichotillosis. They will also be able to give the sufferer a prognosis as to how the condition is likely to develop, and give advice on where to go for help in addressing the problem.
Since the condition is essentially a psychological one, treatment generally involves identifying and addressing underlying anxiety or stress or other causation. Patients suffering trichotillosis may respond to psychotherapy or cognitive behavioural therapy. In some cases, medication that aims to reduce anxiety or depression may be recommended, but there is no specific medical treatment for the condition.
Where a child is showing signs of the condition, the most common treatment is not to intervene, since the habit usually disappears in time.