Mental Health and Trichotillomania
What Is the Treatment for Trichotillomania?
The main treatment for trichotillomania is a type of behavior therapy called habit reversal training. With this approach, a person with trichotillomania first learns to identify when and where he or she has the urge to pull hair. This technique also teaches relaxation as a way to reduce some of the tension associated with the urge and helps the person develop a different behavior to use when the urge to pull hair occurs. This new activity, called a competing response, might be as simple as making a fist with the hand that is used to pull out the hair. Some therapists also use cognitive therapy as a way to address any distorted thinking that might be adding to the stress that triggers the behavior.
In addition, medication might be used as part of the treatment program. A type of antidepressant medication called selective serotonin reuptake inhibitors (SSRIs) might be useful in helping to curb very intense urges.
What Complications Are Associated With Trichotillomania?
Infection, skin damage, and permanent hair loss are possible complications of trichotillomania. The hair loss and skin damage can lead to problems with self-esteem and body image and can have a negative impact on work and relationships. In extreme cases, some people might avoid social situations in order to hide the resulting hair loss.
People who engage in trichophagia (eating hair) are at risk for forming trichobezoars, or balls of hair, in the stomach or small intestines. Trichobezoars can lead to pain, nausea and vomiting, bleeding, blockages, and other serious gastrointestinal problems. Surgery to remove trichobezoars or treat a bowel obstruction may be needed.
What Is the Outlook for People With Trichotillomania?
Children often recover completely from trichotillomania. In adults, however, the disorder tends to be chronic (ongoing) and harder to treat.
Can Trichotillomania Be Prevented?
There is no known way to prevent trichotillomania. However, getting treatment as soon as symptoms appear might help decrease any possible disruption to the person's life, family, and friendships. Stress reduction also might help since stress often triggers the hair pulling behavior.