There are a number of talking and behavioural therapies, which have been found to be helpful in the treatment of trichotillomania. These include:

Habit reversal training (HRT)

This therapy approach is believed to be highly effective in treating trichotillomania. It helps you recognise thought patterns and situations which may increase the likelihood of you wanting to pull your hair. Your therapist will work with you to replace this behaviour with less physically and emotionally damaging behaviours such as clenching your fists or becoming conscious of your hand moving towards your hair and focusing on re-directing it elsewhere on the body.

Cognitive behavioural therapy (CBT)

CBT is a widely used talking therapy that's used to treat a number of psychological difficulties. During CBT, you'll work through the link between your thoughts and behaviours, helping you to become more aware of the unhelpful thought patterns which lead to the overwhelming desire to pull out your hair. Your therapist will ultimately teach you techniques for managing or even changing these dysfunctional thinking patterns in order to relieve your symptoms.       

Acceptance and commitment therapy (ACT)

A type of behavioural therapy, ACT uses mindfulness and acceptance strategies in relation to your behaviour as part of trichotillomania, helping you move past this. It differs from CBT in the sense that you will learn to simply observe and accept the previously unwanted symptoms and events as part of the disorder.          

Medication for Treating Trichotillomania 

There are currently no medications formally approved for the specific treatment of trichotillomania. However, some medications including antidepressants and antipsychotics may help relieve some of the symptoms of the disorder.

When booking your initial assessment with Priory, you may be offered an appointment with a psychiatrist who will help you to consider medication. They will be able to give you an understanding of the side effects of any potential medication in order to determine whether using a particular drug would be beneficial.

Trichotillomania is a mental health disorder characterised by the urge to pull out hair from parts of your body, usually from your scalp, eyebrows or eyelashes. This behaviour happens despite your desire to stop or your awareness of the consequences, including associated pain and the patchy bald spots that are often left when removing hair from your scalp.

Feelings of distress and anxiety may be associated with the urge to pull out your hair, and the act of hair pulling can cause temporary relief from these emotions. The recurring nature of your hair pulling can leave you feeling embarrassed or ashamed, with people suffering from the condition often attempting to hide any visible loss of hair with items of clothing or make-up, which may disguise bald patches.

Trichotillomania is more common in women, and often develops during your teens or early twenties. Without professional support, your symptoms can persist for a long period of time. Treatment for trichotillomania at Priory has been designed to help you ‘re-tune’ your negative thinking patterns which lead to the behaviours associated with the disorder.

Known as an impulse control disorder that's not too dissimilar from OCD, trichotillomania may be triggered or associated with other underlying mental health issues including depression, stress and anxiety. Because many people with the disorder believe they will be perceived negatively by colleagues or their social circle, many people don’t report their condition to GPs or medical professionals, although around 350,000 people in the UK are believed to be affected.

The urge to pull your hair is often felt when you are highly stressed or anxious, although it can occur when you are relaxed or distracted by something else. Some some people with trichotillomania also experience a desire to suck or chew on their hair, particularly if their hair is long. This can result in them eating strands of hair, which can cause additional health problems.   

Many people with the disorder can live perfectly normal lives as long as the condition is managed correctly, usually with the help of talking therapy. Therapy can teach you ways of coping with the disorder without having to avoid social situations or worry about people finding out you have trichotillomania.

Trichotillomania has a recurring cycle of symptoms. You will typically feel increasing tension before you pull your hair out, leading to relief and anxiety reduction once you have pulled a part of your hair out. This can be in response to a stressful situation or when you are distracted to the point where pulling your hair out becomes almost subconscious.

If you have the condition, you may usually pull your hair out from your scalp, although other areas of the body such as your eyebrows, eyelashes, genital area, and beard or moustache may also be involved. Aside from the immediate pain felt when pulling at your hair, which may cause bald patches on your head, you may also feel ashamed, or feel as though the condition is affecting your self-esteem. This can cause you to avoid social situations and keep the impact of the condition to yourself.

The most common signs and symptoms of trichotillomania include:

• Repeatedly pulling your hair out from your scalp, eyebrows, eyelashes or other areas
• Increasing feelings of tension before pulling your hair
• Relief after the hair is pulled out
• Hair loss, thinning or baldness around your head, sometimes in uneven patches or focused on one particular area
• Missing eyelashes or eyebrows
• Biting or chewing hair
• Battling with yourself to stop pulling your hair out, usually without success
• Problems in social situations at school or work which are related to the condition

Pulling your hair will often be done in private and can also include other compulsive actions involved with the body, including picking at your skin or biting your nails. In addition, other items around the house with hair or hair-like qualities including pets, clothes or soft toys may also be pulled.

Trichotillomania is a long-term disorder and can be linked to underlying symptoms of other mental health conditions including anxiety, depression and stress. For this reason, you can often link symptoms of the condition with your moods and emotions, usually split into two categories:

Negative emotions

You may find that pulling your hair is a way of coping with negative feelings of boredom, loneliness or frustration, and can be rooted in more serious mental health conditions such as stress and anxiety.

Positive feelings

The recurring cycle of trichotillomania means that the pleasurable relief felt after pulling your hair out is satisfying enough for you to want to maintain those feelings, hence why the condition can last for an indefinite amount of time and can vary in severity over time.   

It is not yet fully understood what causes trichotillomania, although one factor which may been involved in the condition is a genetic factor. There is evidence that the disorder runs in families, although not everyone with immediate family who have trichotillomania is guaranteed to be diagnosed during their lifetime

As there appears to be links with other diagnoses and other impulsive or mental health conditions including OCD, anxiety and stress, further psychological and emotional triggers could be factors in the likelihood of you developing trichotillomania:

Stress and anxiety

If you experience a particularly stressful event or are exposed to regular sources of stress and anxiety either in your home, school, or work, these are believed to be common triggers of trichotillomania. While it isn’t entirely clear why these symptoms trigger the condition, it would seem that more common anxiety related bodily behaviours such as leg shaking or biting your nails may have been substituted with hair pulling as a way of reducing levels of anxiety and calming the nerves.    

OCD

While OCD is an anxiety disorder in its own right, hair pulling can represent part of the habits or compulsions felt when you have the condition to help cope with obsessional thoughts. Those who have OCD are more likely to have trichotillomania than those without the disorder.

Self-harm

In rare cases, it is believed that trichotillomania may be linked to types of self-harm, due to the pain associated with pulling out your own hair and the psychological relief it provides once the hair has been removed.