Trichotillomania treatment

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This page was clinically reviewed by Colette Miller (BA, BABCP), Cognitive Behavioural Therapist at Priory Wellbeing Centre Birmingham, in January 2022.

What is trichotillomania?

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 you wanting  to stop or knowing about the consequences, including associated pain and bald spots.

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'll 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're highly stressed or anxious, although it can occur when you're relaxed or distracted by something else. 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.

Signs and symptoms of trichotillomania

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

If you have the condition, you may 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 you feel when pulling at your hair, 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.

  • 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

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 you feel 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.

Causes of trichotillomania

It's not yet fully understood what causes trichotillomania, although one factor which may be involved in the condition is a genetic factor. There's evidence that the disorder runs in families, although not everyone with an immediate family member who has 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.


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. People who have OCD are more likely to have trichotillomania than people without OCD.


In rare cases, it's 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.

Treatment for trichotillomania at Priory

Treatment at Priory for trichotillomania takes advantage of growing research into the condition, with talking therapies such as cognitive behavioural therapy (CBT) found to be useful in reducing the severity of symptoms. Priory’s nationwide network of wellbeing centres and hospitals can offer highly specialised outpatient care with experienced therapists and consultants.

Psychological disorders such as trichotillomania are known as impulse control disorders. The condition shares some similarities with obsessive compulsive disorder (OCD), and it's also possible for trichotillomania to co-exist with OCD. The compulsive desire to pull out hair on your body can sometimes cause baldness. Methods of hair pulling could be using your fingers and occasionally tweezers or similar instruments.

Once parts of your hair have been removed, this may temporarily reduce any anxiety you're feeling. Hair pulling usually happens during periods of heightened stress, but it can also happen when you're distracted or relaxed such as when you're reading a book or watching TV. The condition can cause embarrassment; many people with trichotillomania engage in this behaviour in private, with a general desire to hide the disorder from others.

While some people may experience mild and even manageable forms of trichotillomania, if you feel that your compulsive urge to pull your hair is overwhelming, then treatment options available at Priory can help you regain control over these urges and get your life back on track.

Therapy treatment programmes are usually recommended for treating trichotillomania, and would usually be offered to you on an outpatient basis. If you have other mental health conditions that co-occur with trichotillomania, such as depression, anxiety or addictions, a more intensive inpatient treatment programme may also be recommended in order to tackle the underlying cause of the condition.

Trichotillomania treatment near me

We have trichotillomania treatment centres located throughout the country, ensuring that you can access the support you need in a location that's convenient for you. To find your nearest treatment centre, please use the search form below.

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