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You are here:  Home » Learn & Take Action » Guide to the Alopecia's » Trichotillomania
trichotillomania
hair pulling
diagnosing trichotillomania
Trichotillomania is not an easy condition to deal with. We have resources and information to help you better understand the condition and meet others who also struggle with it.

First off, we'd like to invite you to our online community of Trichotillomania sufferers. Its brand new, so we hope you will register and post, to introduce yourself. We've created it just for you, and there are many others with your condition who you can interact with: Click Here to see the Trichotillomania Support Forums.

trichotillomania


Trichotillomania: The name of a psychological condition which results in an obsession with plucking or pulling on one's own body or scalp hair. There are several problems that can result from this activity and the psychology behind it can be confusing. Commonly treatable in children, adults with this condition are less likely to recover completely.

 

What is Trichotillomania?

Trichotillomania is now recognized as being neither so rare nor so benign as previously believed. Patients with trichotillomania studied in dermatological clinics appear normal in their daily behavior, except for the habit causing the alopecia. With young patients, the alopecia is largely regarded as a dermatological condition and diagnosed by a specialist. Typically, the prognosis is guarded or fairly good. However, in a small group of adult patients who have been suffering from trichotillomania for years, the alopecia is usually extensive and difficult to treat, even in spite of psychiatric intervention.

This condition occurs as a result of a person's compulsive hair-pulling/plucking behavior. According to Mehregan (1970), 100 practicing dermatologists evaluated 2-3 cases per year. According to Muller (1990), the condition was far from rare, although not common, both in children and adults. According to a report in 1978, it was estimated that up to 8 million Americans might be affected. Considering its benign self-limited course in most patients, the real incidence in the general population should be much higher than the numbers seen by physicians. In South Korea, practicing dermatologists see only 1 case per year on average.

In children, males most commonly display this activity. In adolescence, it is more common in females. In adulthood, most patients are females.

Diagnosing Trichotillomania

In many cases, clinical diagnosis with inspection of the lesion and patient history is sufficient. A trichogram can be helpful. Quite often, biopsy is needed to differentiate Trichotillomania from Alopecia. Areata. Multiple sections, either vertically or transversely oriented, are recommended to observe characteristic findings. In general, the biopsy should be taken from a new lesion. The most frequent findings are empty anagen follicles (especially in transverse sections), increased numbers of non-inflamed catagen follicles, and pigment casts in hair canals. Distorted or torn away follicles are found infrequently.

Let's take a look at how Trichotillomania is diagnosed.

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