Trichotillomania is the act of repeatedly pulling out one’s own hair from the scalp, eyelashes, eyebrows, pubic area, underarms, beard, chest or legs. This can occur because of an irresistible urge to pull hair or it can develop as a habit. The results of the disorder are evident with a noticeable loss of hair and mental distress, as well as social impairment and/or functional impairment. It is often described as an impulse control disorder, but our experience is that it is really an anxiety disorder which leads to repetitive behaviors, which can include hair pulling, skin picking, and nail biting.
The disorder occurs in all ages from preschool age children, pre-adolescents to young adults, mature adults, and older adults. Determining whether the disorder is an automatic act or a focused hair pulling act, can influence devising and prescribing a treatment plan for Trichotillomania. Children often belong to the “automatic” subgroup who unconsciously pull their hair and do not focus on it consciously. Those individuals who focus on the act of pulling are often pulling hair to create a sensation or sense of satisfaction.
Trichotillomania can start as a result of minor sensory event which act as a trigger, such as itchy eyelashes or stressful events. Depression and anxiety are found more commonly in people suffering from trichotillomania. It is also seen as a habit disorder with boredom associated in some cases. In infants and children, the condition is sometimes temporary; however, in the focused subtype, trichotillomania can become ingrained resulting into a chronic condition.
The problem often goes unreported as patients feel ashamed to admit to hair pulling which could result in deliberate isolation, with the patient trying to stay away from social and educational pursuits or to curtail work. This fear of getting exposed prevents many from getting medical help of any kind. It can also lead to strained relationships and ugly situations within the family.
Keep in mind that no single approach is best suited for every patient with trichotillomania. Every patient whether child, adolescent or adult has to be treated according to their personal situation, behaviors, and needs. Behavioral therapy is often a key component to successfully treating trichotillomania. Standard medications offered by most psychiatrists are typically those used to treat depression and are associated with innumerable side effects, without actually reaching the root cause. The physicians at Neuro-Luminance understand the neurobiology of trichotillomania and have a strong track record of reducing or eliminating hair pulling or skin picking behaviors with medications that directly influence the circuitry of the behavior. By the use of a thorough understanding of pharmacology and individualized analysis of the patient’s neurobiology, the Master Psychopharmacology evaluation can target effective treatment for this vexing disorder.