Tasneem Abrahams
March 26

Trichotillomania (trik-o-til-o-may-nee-uh) is a disorder that involves recurrent, irresistible urges to pull out hair from your scalp, eyebrows, or other parts of your body, despite trying to stop. The cause of trichotillomania is unclear, but like many complex disorders, trichotillomania probably results from a combination of genetic and environmental factors. Also, abnormalities in the natural brain chemicals serotonin and dopamine may play a role in trichotillomania.

Signs and symptoms of trichotillomania often include:

- Repeatedly pulling your hair out, typically from your scalp, eyebrows or eyelashes, but can be from other body areas, and sites may vary over time

- An increasing sense of tension before pulling, or when you try to resist pulling

- A sense of pleasure or relief after the hair is pulled

- Shortened hair or thinned or bald areas on the scalp or other areas of your body, including sparse or missing eyelashes or eyebrows

- Preference for specific types of hair, rituals that accompany hair pulling or patterns of hair pulling

- Biting, chewing or eating pulled-out hair

- Playing with pulled-out hair or rubbing it across your lips or face

Treatment Options

Options for treatment of trichotillomania (TTM) include:

- Support groups

- Medication

- Cognitive Behavioural Therapy (CBT)

- Alternative Therapies

The most well documented methods of reducing hair pulling are cognitive behavioural therapies (CBT) and medication. Body Focused Repetitive Behaviours (BFRB) such as trichotillomania is initiated by many triggers, and so treatment requires a detailed and broader approach that deals with as many of these triggers as is possible. Not all sufferers are affected by the same triggers and neither are they affected in similar ways. Therefore treatment needs to be customised for each patient. It has been found that a common trigger for this condition lies in the cognitive/psychological areas of the sufferer. Problems in these areas are best treated today with the use of cognitive therapy. Cognitive therapy can assist in addressing the distorted beliefs the patient could have in relation to their pulling behaviour. However, these approaches are not always effective. Alternative Therapies such as changes in diet, meditation, hypnosis, prayer, yoga and herbal remedies have shown to assist in the treatment of this condition. It is important to note that these therapies have not been scientifically tested and evidence of effectiveness is anecdotal.

Hypnosis as an Alternative Therapy for Trichotillomania

The American Psychological Association describes hypnosis as a cooperative interaction in which the participant responds to the suggestions of a hypnotist. The technique has been clinically proven to provide medical and therapeutic benefits, most noticeably in the reduction of pain and anxiety. Substantial research documents the effectiveness of clinical hypnosis for the treatment of a wide range of emotional, medical, and behavioural problems. Two thirds of trichotillomania sufferers say they go into a trance (hypnotic) state when pulling their hair. Understanding this behaviour and bringing it under control assists with using hypnosis as a tool to treat this condition. Using hypnosis in addition to an existing treatment program has been shown to substantially increase treatment success.