Article in News May 1, 2012

If that unexplained baldness is leaving you upset, you might want to check if you’re responsible for ‘pulling’ your hair out

Your mane is your crowning glory and you’d go to great lengths to groom it, style it and flaunt it. I mean, who doesn’t want a head full of lustrous, gorgeous hair that can be tweaked any which way for a whole new look and a bunch of admiring stares? But imagine a situation where you were forced to cover bald patches using cosmetic tricks. And all this because you have this imp­ulse to pull out your hair! Soun­ds far-fetched? Why would anyone in their right frame of mind, ever want to pull out their hair? But for several youngsters however, trichotillomania is a reality.

“Trichotillomania is an irresistible urge to pull out hair. While the reason is not known, it is known to affect people usually in their adolescence. It is also more commonly seen in women than in men,” says Dr Phani Prasant, consultant psychiatrist at Care Hospital.

“The exact reasons for this condition are not known, however, different people give different explanations. The reasons could range from the fact that the act of pulling out hair gives them pleasure to it being a way for people to relieve anxiety,” says Dr MS Reddy, psychiatrist at Asha Hospital.

Often people who suffer from trichotillomania don’t even realise that they have a problem. It is only when people around them begin to notice bald patches, do they seek help. Most often they assume that the hair loss is due to a dermatological or trichological reason and approach a skin or hair specialist. “It is only when all other reasons are ruled out, do they consider the possibility of it being trichotillomania. The condition falls in the spectrum of obsessive compulsive disorders. One of the most common patterns that we noti­ce in people with trichotillomania is that once they notice a ba­ld patch, they keep tinkering wi­th the area in a bid to make it a perfectly circular patch,” says Dr Reddy.

People with trichotillomania go to great lengths to disguise the bald patches. “They will use hair from the other side of the head to camouflage the bald patches or wear an accessory to cover it up,” says Dr Prasant.

For some people, trichotillomania may be mild and generally manageable. For others, the urge to pull hair is overwhelming and can be accompanied by distress. Some treatment options have helped many people reduce their hair pulling or stop entirely. “Fortunately, the condition is not too common in our country and we at the most see around one case in a month or two,” says Dr Prasant.

In some cases, people do tend to ingest the hair roots as well. “We’ve had cases where a person with trichotillomania eats his/her hair and ends up with a condition called trichobezoar, a condition in which a mass of hair is found trapped in the stomach, due to ingestion of hair,” says Dr Prasant.

“When it comes to treatment, trichotillomania is treated like any other compulsive disorder. The patient is recommended behaviour therapy or relaxation techniques so they can get rid of the habit. If none of this works then tricks like making them wear a cap on the affected areas or using a bandage to tie up their fingers so they cannot pull out their hair helps. While some people respond well to treatment, others do not,” says Dr Reddy.

Symptoms of trichotillomania

• An uneven appearance to the hair
• Bare patches or all around (diffuse) loss of hair
• Bowel blockage (obs­tru­ction) if people eat the hair they pull out
• Constant tugging, pulling, or twisting of hair
• Denying the hair pulling
• Hair regrowth that feels like stubble in the bare spots
• Increasing sense of tension before the hair pulling
• Other self-injury behaviors
• Sense of relief, pleasure, or gratification after the hair pulling