Trichotillomania is chronic and repetitive hair pulling. It is categorized as an impulse control disorder that appears to share different elements with Obsessive-Compulsive Disorder, Body Dysmorphic Disorder and Tourette’s Disorder. Models of trichotillomania indicate that it is either a malfunction of brain chemistry or of particular structures in the brain. Although the diagnostic criteria includes a feeling of tension before pulling and a sensation of pleasure or gratification once the hair is pulled, some individuals do not seem to experience this sequence. However, trichotillomania appears to have a strong sensory component which results in feelings of relaxation or pleasure when pulling. Some individuals may have little or no awareness of their pulling while in contrast others may pull in an alert and systematic manner.
Hair may be pulled from any area of the body, such as scalp, eyelashes, arms, legs, etc. The scalp though is the most common site. In addition to the act of pulling, individuals may engage in further ritualized behaviors, including stroking the hair against the face or mouth, playing with the hair, saving and or biting/chewing it.
This disorder is treated most effectively with a particular type of behavioral therapy, habit reversal training.
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