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Trichotillomania

This is a disorder that appears due to patients hair  pulling behavior.  The patient does not accept this and the history is often “hollow” with no reasonable explanation for hair loss.  Children are more affected and among adults, women predominate.

Typically there is an area of hairloss along the scalp but sparing the margins.  The hair loss is not complete and about 0.5 – 1cm of hair remains.  This represents the hair that cannot be pulled in a thumb grip.

 Various stresses and emotional reactions induce the disorder.  It later becomes a compulsive habit.

 Skin biopsy may be done.

Trichogram (microscopical examination of plucked hair helps)

 Treatment

One method to demonstrate that hair follicles are growing normally is to regularly use an electric shaver to the affected area.  This will result in all the hair growing out to a depth of 0.5 cm when not shaved for a week.  Several weeks may be required.

In adults, patients do not accept the diagnosis and detailed psychiatric evaluation may be necessary.