Thursday, April 23, 2009


Trichotillomania (Trich) is an impulse control disorder characterized by repeated pulling of the hair, often leading to bald spots. A patient suffering from Trichotillomania typically pulls hair from one specific spot on the body in a habitual, repeated way. Head hair, nose hair, eyebrows, and pubic hair are all common areas for Trich. The disorder is thought to be an amalgum of Obssessive Cmpulsive and Movement disorders. Since many people suffering from Trich are not even aware that they are pulling out their hair when they are doing it, many place it in the same category as nail biting, which has a similar habitual pattern.

Trichotillomania has an estimated prevalence rate of 1% worldwide. It is thought that the disorder was previously under reported but that reporting has increased in the past decades as the stigma surrounding compulsive disorders has lessened and psychological care has become more ubiquitous.

There are very stong indications that Trich is hereditary. Scientists isolated a gene they believed to be responsible for the behavior, and when they injected lab rats with it, those rats started to rip out their own and others hair. Stress is a common trigger for Trich behavior. Most trich patients will show no hair pulling behavior in a stress-free situation, but will immediately engage in the behavior when presented with stress.

Treatment often includes both behavioral and drug therapy. Tricyclic antidepressants are more effective than SSRIs (like prozac) in the treatment of Trich. Behavioral treatments have to do with understanding what situations serve as triggers for the behavior in order to increase awareness and develop strategies to avoid engaging in the behavior in those situations.

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