Trichotillomania: how to end this compulsive hair pulling disorder?

What is trichotillomania and who can be affected?

Trichotillomania is a behavioral disorder, which pushes the sufferer to pull out their hair or hairs (eyelashes, eyebrows, beard, armpit, nose hair, etc.). Sometimes leading to alopecia (absence of hair / hairs) more or less extensive, and variable over time. Most of the time, trichotillomania manifests itself in the form of a crisis: the trichotillomania cannot prevent himself from being pulled out for a certain period of time (from a few minutes to a few hours). At this moment, it is like in a daze. Moreover, it is very difficult for a trichotillomaniac to come out of a crisis.

Trichotillomania is also part of “repetitive behaviors centered on the body” (CRCC), just like dermatillomania (or excoriation disorder), which consists of constantly triturating the skin or onychophagia, which corresponds to obsessively biting nails.

According to the Association francophone des CCRC, trichotillomania affects 1 to 2% of the population. Some studies even speak of 4%. It can affect all ages. In adults, this ocd affects women in 9 out of 10 cases. In children, it is more often boys who are concerned.

Moreover, the disorder will differ according to this last criterion, that of age. And for good reason, depending on whether it concerns an adult or a child, trichotillomania changes. In children, trichotillomania is most often linked to a temporary episode of stress. In adults, it will be more of a psychological disorder, characterized by difficulty in controlling impulses. The Association francophone des CCRC distinguishes between two clinical forms (which can coexist or succeed in the same person):

  • centered on the gesture: grubbing is a pressing need that will be followed by a feeling of appeasement and then guilt.
  • automatic: the uprooting is neither premeditated, nor even conscious. It does not cause satisfaction or relief and is done most of the time automatically (in front of the television for example).

What is the cause of trichotillomania?

Studies have not yet shown a specific cause for trichotillomania. However, several risk factors seem to be at the origin:

  • genetic background (heredity)
  • trauma suffered (focused tearing, it then takes the function of focusing the conscious attention to avoid anxiety-inducing thoughts)
  • stress, anxiety, boredom …
  • emotional shock

What are the symptoms of trichotillomania?

If we do not necessarily talk about symptoms when we talk about a disorder such as trichotillomania, we do identify some concrete disorders:

  • feeling of relief after pulling up then guilt
  • absence of other mental disorders or skin conditions
  • obsessions and crises. The trichotillomaniac cannot prevent itself from pulling out for a certain period of time (from a few minutes to a few hours). At this moment, it is like in a daze.
  • significant suffering at social, professional or other level. And for good reason, in some cases, trichotillomania can lead to more or less extensive alopecia, and variable over time. It then becomes difficult to hide this disorder from a social point of view. The individual can then develop shame and guilt.

Are there treatments to overcome it?

The first phase of healing is awareness of the disorder. It is important to inform those around him (who should absolutely not blame him for this disorder. These are uncontrollable impulses). Secondly, consultation with a psychologist or a child psychiatrist will be necessary to determine the origin of the disorder and then to undo the thought mechanisms of the person concerned. The professional will be responsible for setting up rituals that will channel the anxieties and stress of the person in question. As a last intention, pharmacological treatment may be indicated to the patient.

In children, the disorder usually goes away on its own.

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