Trichotillomania (which is pronounced’ trick-oh-till-oh-may-nee-ah’), thankfully, is known by a much easier name; hair pulling. It’s sometimes referred to as just ‘trich’ or even TTM.

Here, you can find out everything you wanted to know about Trichotillomania (or at least we hope so!). You can click (or touch) each of the headings below to find out more about specific aspects of the condition.

We hope you find the information useful and if you do, please feel free to share it.


Trichotillomania is a long-term, chronic condition whereby people have the urge to pull out the strands of hair on their head, arms (and pits), legs, pubic area or even eyelashes. Technically, it is classed as a 'Body-Focussed Repetitive Behaviour' (BFRB). Because trichotillomaniacs find it VERY difficult to stop pulling their hair (because it's a compulsive action), it has links to OCD but, unlike OCD, it tends not to be initiated by an negative intrusive thought.

As nature of the condition suggests, those living with the illness will often undergo hair loss. This is usually done with their fingers, but some people use tweezers. This can go on to affect how they feel about their looks, making them feel guilty or embarrassed and negatively impacts on their self-esteem. Those with trichotillomania generally don't pull their hair to hurt or harm themselves. It is often done to relieve tension or stress that has been building up in their lives. Many do it instinctively and don't even realise they are doing it at the time. This is known as automatic, as opposed to focussed, when it is done intentionally. It is not an 'either / or' situation.

Depending on the mood or situation, people may do it automatically, whilst at other times it may be focussed pulling.


Trichotillomania often occurs in time of stress or anxiety. There is no hard and fast rule about what causes it, but many people believe it is caused by a combination of genetic and environmental factors. An imbalance in your natural brain chemicals, like dopamine and serotonin, may also play a part in the development of trichotillomania.


If the conditions begins to develop during childhood, then the split between male and female is about equal. AS teenagers or young adults, then it tends to affect more girls than boys. If it continues into adulthood, more women tend seek treatment for it than men, but this is often because women are more likely to seek help for any condition than us blokes!


The symptoms of trichotillomania are fairly easy to spot, even if the underlying causes are not. Symptoms vary between mild and severe and can include:

  • Pulling your hair repeatedly, to the point where hair loss becomes obvious and noticeable.
  • The absence of other medical conditions that might cause loss of hair, i.e. a skin or scalp condition.
  • Feeling tension or anxiety which is relieved when hair is pulled out.
  • Affecting your daily life to the point where it causes you distress.
  • Playing with the hair that has been pulled. This can include biting, chewing or even eating the hair.

Many people with trichotillomania also find that they pick their skin, bite their fingernails or chew the skin on the inside of their lips, but this is not always the case.


The most common treatment for Trichotillomania is a form of CBT called Habit Reversal Training. Your GP can refer you to it, or some places will allow you to self-refer.

In basic terms, it is designed to replace the habitual hair-pulling with something that's not harmful. Treatment will always be indiviudal, but generally, you would be expected to keeping a diary, learn and understand what triggers it or replace hair-pulling with something else, e.g. squeezing a stress ball. In many cases, your family and friends will play a part in the treatment to provide you with emotional support.


As is always the case, learn more about the condition. The more you know, the better placed you are to help them. There are a number of things you can suggest that may help them with their hair-pulling. Just telling them not too, really isn't going to help. You could offer them stress-busting 'toys' like fidget-cubes or stress balls to use when they feel the urge.

Bear in mind that those living with trichotillomania will often feel guilty and a sense of shame afterwards. This can be made worse when they know someone else is aware of it. As such it's crucial that you listen to them without judgement but with understanding and acceptance. Encourage them to seek help and, if appropriate, accompany them to see a Doctor.

If you suffer with Trichotillomania, there may be some organisations on our Where To Turn pages that can help you. If not, and you know of one, please let us know and we'll look into it.

Also, if you'd like to share your experiences of living with trichtillomania with our community so they can better understand how it feels, please take a look at our 'Men Tell' section.