Trichotillomania
involves the repetitive, uncontrollable pulling of one’s
body hair. Most commonly, scalp hair, eyelashes, and eyebrows
are pulled, although hair may be pulled from any location. Typical
symptoms include:
Recurrent pulling out of one's hair resulting in noticeable hair
loss.
An increasing sense of tension immediately before pulling out
the hair or when attempting to resist the behavior.
Pleasure, gratification, or relief when pulling out the hair.
The disturbance causes clinically significant distress or impairment
in social, occupational, or other important areas of functioning.
The
disturbance is not better accounted for by another mental disorder
and is not due to a general medical condition (e.g., a dermatological
condition).
Associated
features of Trichotillomania include: examining the hair root;
twirling it off; pulling the strand between the teeth, or trichophagia
(eating hairs). Nail biting, scratching, gnawing, and excoriation
may be associated with Trichotillomania.
Differential
Diagnosis:
Some disorders
have similar or even the same symptoms. The clinician, therefore,
in his/her diagnostic attempt, has to differentiate against
the following disorders which need to be ruled out to establish
a precise diagnosis.
Cause:
Trichotillomania
is found predominantly in females and tends to occur more often
in children than adults. The disorder usually begins between early
childhood and adolescence. In
some cases, trichotillomania is related to an increased stress
level at home or school, while for other children, it is simply
a learned habit that has strengthened over time.
Treatment:
The primary treatment approach for Trichotillomania is habit reversal
combined with stress management and behavioral contracting. Parents
can help by recognizing the problem in its early stages and getting
involved in its treatment.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Treatment
may involve self-monitoring of hair-pulling episodes as well as
the feelings and situations that are most likely to lead to hair
pulling. Youngsters are then systematically introduced to new
behaviors, for example, squeezing a ball or tightening their fist,
whenever they feel the urge to pull at their hair.
Relaxation training and other stress reduction techniques may
also be used including reward charts that help track and monitor
a child's progress with the added incentive of earning small rewards
for continued progress. In addition, cognitive therapy, is found
to be effective.
