Mental Health

Trichotillomania (hair pulling disorder)


Trichotillomania (TTM) is a disorder characterized by the recurrent urge to pull out one’s own hair, which can lead to noticeable hair loss and distress. The hair can be pulled from any part of the body, such as the scalp, eyebrows, eyelashes, beard, and pubic area. It is classified as an obsessive-compulsive and related disorder.


There are different subtypes of TTM, including:

  • Focused TTM: This is when a person primarily pulls hair from one specific part of the body, such as the scalp.
  • Diffused TTM: This is when a person pulls hair from multiple parts of the body, such as the scalp, eyebrows, and eyelashes.
  • Impulsive TTM: This is when a person pulls hair impulsively, without planning or premeditation.
  • Compulsive TTM: This is when a person pulls hair in response to an irresistible urge or compulsion.


The causes of TTM are not fully understood, but it is thought to be caused by a combination of genetic, environmental, and psychological factors. Some studies suggest that TTM may be related to abnormal brain function, which makes it difficult for a person to regulate their impulses and emotions.

Symptoms of TTM include:

  • Recurrent and irresistible urges to pull out one’s own hair.
  • noticeable hair loss and thinning, which can be accompanied by patchy baldness or bald spots.
  • Difficulty resisting the urge to pull out one’s own hair.
  • Feelings of shame, guilt, or embarrassment about hair pulling.
  • Social isolation and difficulty maintaining relationships


Diagnosis of TTM is typically made by a mental health professional, such as a psychologist or psychiatrist, through a combination of a clinical interview and a review of the person’s symptoms.


Treatment options for TTM include:

  • Therapy, such as cognitive-behavioural therapy, to help a person learn how to manage their hair pulling
  • Medication, such as antidepressants, to help with symptoms of anxiety or depression that may be associated with TTM
  • Habit reversal therapy (HRT) is a type of CBT that helps a person to identify the triggers, thoughts and feelings that lead to hair pulling and then learn new, healthier ways to respond to those triggers
  • Supportive services, such as case management and vocational rehabilitation, to help a person with TTM lead a more independent life


It’s important to note that TTM is a chronic and recurrent condition that requires a comprehensive treatment approach, involving therapy, medication, and support services. It’s also important to seek professional help if you suspect that you or a loved one might have TTM as it can have a significant impact on the person’s well-being.


For further support and information please book an appointment with our specialists….


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Dr Ibrahim Yahli MD MRCPsych

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