Trichotillomania is the act of uncontrollable hair pulling. If the hair pulling continues for long enough, permanent hair loss can occur as a result. Trichotillomania can cause hair pulling throughout the body, and is not limited to just the head. Those with this disorder typically pull on head hair, facial hair, eyebrows, pubic hair, underarm hair, chest hair, or hair on the arms and legs.
It is important to recognize that this is not an indication of mental illness or impairment, and certainly does not mean that a person may be violent or unpredictable. It is usually a coping mechanism that may or may not relate to anxiety or fear. Sometimes people with TTM pull their hair out as a response to other emotions such as a boredom or even frustration or sadness. The reasons for TTM can actually be very logical, and usually centers around a desire for others to perceive them a certain way. For example, a person with TTM may simply be obsessed with keeping grey hairs off of their body due to cultural stigma, or obsess about the shape of their eyebrows for the exact same reason. Some people with TTM simply derive a sensory satisfaction from the texture of the hair, or the physical sensation of pulling the hair from their scalp. Finally, some people are triggered by a certain setting. For these people, they only exhibit TTM while in a specific room or while doing a specific activity such as studying or reading. Sometimes they are not even aware of their TTM until they notice hair loss themselves, or somebody else notices first.
According to the American Psychiatric Association, to be diagnosed as having TTM, a person most display the following:
TTM usually responds well to cognitive-behavioral therapy, which first identifies the problem and then goes on to identify the stressors which trigger it. The overall goal of this form of therapy is to make the TTM-sufferer undergo a sort of self-analysis that allows them to recognize their behavior, and then prevent it. For cognitive-behavior therapy, a licensed psychologist should be used. These professionals will know the appropriate strategies to use to combat TTM and make their patients more aware of their behavior at all times of the day, even when they are particularly stressed or otherwise inclined to pull their hair. Although TTM can come on at any age, it can usually resolve itself through therapy. If the behavior has been present for a long time, however, it will be more difficult to overcome.