They may do this intentionally or unconsciously.

This condition can lead to significant hair loss, but it is treatable.

Recognizing the signs early on can ensure that people get the treatment they need to prevent further damage.

Faceless portrait of woman with beautiful hair

baranova_ph / Getty Images

Explanations for such behavior aren’t clear, but experts believe that genetics and family history play a role.

Understandably, people may take a stab at hide the behavior, making diagnosing it more complex.

Trichotillomania treatments typically involve cognitive behavioral therapy, habit reversal training, or exposure therapy.

The hair-pulling behavior has even rarely been reported to happen during sleep.

One twin study suggested a heritability estimate of 76.2%, indicating that genetics plays a significant role.

Another twin study conducted in the UK estimated that heritability was around 32%.

Co-Occurring Conditions

Evidence suggests that trichotillomania is highly comorbid with other conditions.

How Is Trichotillomania Diagnosed?

Diagnosis may be complicated as alopecia areata itself can sometimes trigger trichotillomania.

Trichotillomania is a relatively rare illness, affecting 1% to 2% of the population.

Roughly 90% of adults with the condition are female.

Children less than 5 years old often pull their hair out unknowingly.

Among people in this age group, trichotillomania tends to be chronic in nature.

Psychotherapy

Cognitive behavioral techniqueshave demonstrated some efficacy in treating trichotillomania.

For more mental health resources, see ourNational Helpline Database.

The TLC Foundation for Body-Focused Repetitive Behaviors.What is trichotillomania (hair pulling disorder)?

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders.

5th ed, text revision.

Washington, D.C.; 2022.

Woods DW, Houghton DC.Diagnosis, evaluation, and management of trichotillomania.Psychiatr Clin North Am.

2024;133:152506. doi:10.1016/j.comppsych.2024.152506

Henkel ED, Jaquez SD, Diaz LZ.Pediatric trichotillomania: Review of management.Pediatr Dermatol.

2019;36(6):803-807. doi:10.1111/pde.13954

Merck Manual.Trichotillomania.

Grant JE, Chamberlain SR.Trichotillomania.Am J Psychiatry.

2016;173(9):868-874. doi:10.1176/appi.ajp.2016.15111432

Grant JE.Trichotillomania (hair pulling disorder).Indian J Psychiatry.

2019;61(Suppl 1):S136-S139.

doi:10.4103/psychiatry.IndianJPsychiatry_529_18

Bruce TO, Barwick LW, Wright HH.Diagnosis and management of trichotillomania in children and adolescents.Paediatr Drugs.

2016;40(3):414-38. doi:10.1177/0145445515616369