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If you struggle with compulsive hair pulling from different parts of your body, you may be suffering from trichotillomania. This condition can be treated. Here we will explain what it is and how it can be treated.

What is trichotillomania?

Trichotillomania involves repeated hair pulling resulting in hair loss. Hair pulling can be done all over the body, but the most common areas are the eyebrows, eyelashes, scalp and genitals. Often, people look for hairs that stick out, but they can also pull hair from other people or objects such as clothes or toys. They may watch, play and/or swallow hairs. Adults and children can be affected, and if you are a child, it is particularly important to seek help, as swallowing hair can be dangerous.

The cause of trichotillomania is a combination of genetic and environmental factors. Often, people try to stop their behaviour without success and may feel bad about it, which can also affect their functioning at school and work. Trichotillomania can co-exist with other mental health problems such as anxiety, depression, dysmorphophobia, Obsessive-Compulsive Disorder (OCD) and Autism Spectrum Disorder. Self-harm is often aimed at harming oneself and is, therefore, different from trichotillomania.

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How common is trichotillomania?

Studies of adults have shown that between 0.6% and 3.4% of the population have the diagnosis. Trichotillomania is ten times more common in women than men, according to research. There are currently no studies on how common it is in children and adolescents, but the problem exists here too.

Trichotillomania in ADHD

Studies have shown that trichotillomania is more common in people who also have ADHD and ADD. People with neuropsychiatric problems and trichotillomania have been found to be more impulsive. If you suffer from this, it is important to seek separate help for trichotillomania, as this diagnosis did not improve with treatment for ADHD alone.

Symptoms of trichotillomania

If you suffer from trichotillomania, where you have compulsive hair pulling, you have often tried to stop the behaviour. They may have noticed that it also affects their school or work, causing distress. Around 80% experience an inner tension that is released with the pulling. Here are some more symptoms:

  • Before beginning the behaviour of hair pulling, you may experience feelings of anxiety or restlessness, among others.
  • Twitching can be done both consciously and unconsciously. It usually occurs in front of family members but not in front of strangers.
  • It is most commonly found on the scalp, eyebrows, eyelashes, and genitals, but it can also be from toys or other people.
  • People look for a particular hair to pull and may examine, play with or swallow the hair.

If you recognize the symptoms of trichotillomania, you may want to seek help. For milder symptoms, we have psychologists at Lavendla who can help. If you have more severe problems, seeking help via specialist psychiatry is good. Below, you can read more about what treatment can involve.

Treatment of trichotillomania

Cognitive Behavioural Therapy (CBT) is the most effective treatment for trichotillomania. Treatment techniques have also been combined with stimulus control and Habit Reversal Training (HRT). HRT has also been studied in addition to Acceptance and Commitment Therapy (ACT) or Dialectical Behaviour Therapy (DBT), and it has been helpful. It has been found that following up on the treatment is important to maintain the effect over time.

HRT treatment consists of three parts:

  1. Mindfulness training
  2. Countermovement training
  3. Social support.

There is also work on stimulus control, which means dealing with situations where hair-pulling often occurs. To reduce twitching, you can, for example, cover mirrors, change to dimmer light bulbs, avoid chairs with armrests or use gloves in certain situations. Trichotillomania is a condition that varies in severity from mild to moderate to severe. For milder problems where you do not experience such great suffering and/or have reduced function, you can go into treatment with a psychologist or CBT therapist at Lavendla. If you have more severe problems, you should primarily be treated in specialist psychiatric care, and then you can go to your health centre to get a referral. In terms of medical treatment with drugs, there is not yet enough research to be able to give a recommendation on medication.

Seeking help can change your life

Trichotillomania is not something you have to deal with alone. Talking to a psychologist can help you understand your condition better and offer effective ways to deal with it. You are not alone, and it is okay to ask for help. Our website has qualified therapists and psychologists who are happy to help you overcome these behaviours.


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Common misconceptions about therapy

Many people believe that therapy is only for “serious” cases or that seeking help is a weakness. In both cases, these are misconceptions. Therapy is a step towards improvement, and we make the difficult easier by connecting you with qualified therapists and psychologists online and onsite.

Your next step

If you or someone you know is struggling with trichotillomania, it’s a good idea to talk to a professional therapist or psychologist. We assure you that all therapists and psychologists on our platform are qualified and your conversation is always confidential. Don’t be afraid to take the first step.

Living with trichotillomania can be a daily struggle, but help is available. You can significantly improve your quality of life with the right support and tools. We are here to support you if you are ready to take the plunge. Book your first session today and start your journey towards a better future.


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12 FAQs about Trichotillomania

What is trichotillomania?

Trichotillomania means repeated hair pulling, which results in hair loss. Hair pulling can be done from all over the body, but the most common areas are the eyebrows, eyelashes, scalp and genitals.

How is trichotillomania diagnosed?

A psychologist or psychiatrist usually diagnoses trichotillomania through tests and assessments, including questionnaires and clinical interviews.

Is trichotillomania hereditary?

Research shows that trichotillomania may have a genetic component but it is not the only factor. Environmental factors also play a role.

What are the symptoms of trichotillomania?

Symptoms include hair pulling from all over the body, but the most common are eyebrows, eyelashes, scalp, and genitals. People often look for hair that sticks out, but they can also pull hair from other people or things like clothes or toys. They often watch, play with, and/or swallow hairs.

How is trichotillomania treated?

Treatment can include Cognitive Behavioural Therapy (CBT) with specific Habit Reversal Training (HRT) and stimulus control, which has been shown to be particularly effective. Adding Acceptance and Commitment Therapy (ACT) or Dialectical Behavioural Therapy (DBT) may also be helpful.

Is there a cure for trichotillomania?

With proper treatment, symptoms can improve significantly, and monitoring results over time is important.

Can children get trichotillomania?

Yes, children and teenagers can also be affected. It is important to seek professional help as soon as possible for the best possible treatment outcome.

How common is trichotillomania?

Studies of adults have shown that between 0.6% and 3.4% of the population are diagnosed.

Does trichotillomania affect my ability to work?

Yes, in severe cases, trichotillomania can lead to work disability. However, it is possible to return to normal function with proper treatment.

Is trichotillomania more common among women or men?

Trichotillomania is ten times more common in women than men, according to research.

Can you have other problems at the same time as trichotillomania?

It is also common to have other psychological conditions such as anxiety, depression, dysmorphophobia, obsessive-compulsive disorder, autism and ADHD. It is important to get an assessment by a licensed professional.

How do I get help with my trichotillomania?

At Lavendla, we have experienced psychologists and therapists working with CBT who can help you feel better if you have mild symptoms. If you have more severe symptoms, you can contact your health centre to get a referral to a specialist psychiatrist. If you have thoughts of self-harm or suicide, contact 0800 456 789 or the nearest emergency department.

What does treatment for trichotillomania involve?

Seeking help is a big step towards better health; controlling your feelings is positive. Here is an overview of the steps typically involved in treating trichotillomania.

Step 1: An initial assessment session

The first meeting with your psychologist or therapist assesses your mental and physical health. You may be asked questions about your life situation, feelings, thoughts and behaviours. You may also be asked to complete assessment forms.

Step 2: Goal setting

This is where you and your therapist set concrete goals for the therapy, both short and long-term.
It can define which areas of your life are most affected by your well-being and how you would like to change them.

Step 3: Treatment with different techniques and tools

This is the treatment phase, which involves exercises to give you tools to overcome your problem. Habitual Reversal Training (HRT) and stimulus control are often used.

Step 4: Monitoring and evaluation

Treatment is monitored regularly to see how well the therapy is working. If necessary, the treatment plan can be adjusted or renewed.

Step 5: Ending and looking ahead

As the therapy ends, it is time to reflect on the progress. You will also receive a maintenance plan for using the tools and strategies you have learned in the future. It is also important to monitor the results over time.

If you or someone close to you is looking for professional help, don’t hesitate to book a session with one of our licensed psychologists or therapists.


Written by Samantha Pieterse

Sr. Samantha Pieterse is a registered psychiatric nurse who is deeply committed to mental health and well-being. Samantha brings a unique and valuable perspective to her role as an editor for Lavendla South Africa. She has worked in Government and Private mental healthcare institutions in Gauteng and her expertise ensures that the articles on our website are accurate and accessible. Samantha is dedicated to enhancing mental health awareness and education in South Africa.