Trichotillomania (TMT) is a medical disorder in which a person intentionally pulls and/ or picks at otherwise healthy hair until permanent baldness occurs. Actually, the patient experiences an irresistible urge to pull out hair from the scalp, eyebrows, or eyelashes. In some cases, the hair pulling may be harmless, a temporary habit similar to thumb-sucking. The pulling out of individual strands of scalp hair is the norm, but pulling eyebrows, eyelashes or pubic hair defines other aspects of this condition. Most patients go to great lengths to disguise the patchy bald spots that result.

If the behaviour is excessively repeated over a period of time, this could indicate a psychiatric or serious emotional condition. Most pullers are children or young adults, and the behaviour has been associated with the habitual rituals of obsessive-compulsive disorder (OCD)—where a person attempts to ease repeated, unwanted thoughts by substituting with hair pulling. Eventually, the hair is removed from the skin and disposed of.

Therefore, patients who suffer from trichotillomania (ttm) are of two types:

• Those who pull out hair regularly, but may not understand their behaviour or

• Realize why it’s happening Those who intentionally who pull their hair to get sensual pleasure from it or

• Because an itch or pain needs relief

To diagnose TMT, a thorough evaluation by a certified professional must be performed. This may involve determining how much hair loss has occurred, and considering the patient’s answers on a questionnaire geared to help diagnose this condition. In some cases the care provider may take a biopsy of the hair and/or skin to help pinpoint the problem. In serious cases, a diagnosis may include criteria indicated in the Diagnostic and Statistical manual of mental Disorders (DSI), published by the American Psychiatric Association.

A DSM assessment considers the following:

• Hair pulling that is consistent and causes visible hair loss

• Just before pulling, when the puller is trying to resist pulling, he or she

• Experiences an increasing sense of tension or anxiety

• The puller experiences a sense of pleasure or relief when pulling

• The puller experiences significant distress without pulling

• Determining whether hair loss is not caused by another medical or dermatologic illness

Treatments for this disorder vary depending on the severity and individual facets of each case. For instance, in the case of younger children, one tactic has been to cut the hair, making it impossible to pull. With older children and young adults, setting up a means of self-monitoring to improve awareness of (and decrease denial) the behaviour. Specified records of occurrence— regarding the time, situation and the number of hairs pulled out—are often kept.

In some cases, a psychotherapy technique called behaviour modification may help. And finally, the choice to use an SSRI (serotonin re-uptake inhibitor) anti-depressant provides another alternative. In some cases, cylomipramine medications may prove effective. Another important facet to treatment may include a support group. It is useless to perform hair transplants for these patients until the disorder has been cured, as they will simply pull out the newly transplanted hair.

When the treatments mentioned here don’t work, another less conventional therapy is available. Once the other treatment criteria have been exhausted, some therapists use hypnosis such as it’s used in helping people to stop smoking, lose weight, overcome phobias, and cope with insomnia and stress. Research has indicated hypnosis has been helpful in such goals.
After all, when a person suffers on a daily basis with a crippling disease, it’s important to explore all options with the assistance of a certified health care professional.

Treatment Of Trichotillomania (Hair Pulling Disorder)