A lack of definitive cause for trichotillomania makes treatment difficult, and the prognosis for a total recovery is poor, although the behavior may be satisfactorily controlled with therapy.
According to the American Psychiatric Association there are five criteria which must be met in order for trichotillomania to be diagnosed.
Addressing the behavior of trichotillomania in a group setting is helpful so the patients realize that they are not the only ones with this problem.
All of this makes the diagnosis of trichotillomania difficult.
Altered dopamine levels may also play a role in trichotillomania.
Among college students surveyed, more than 10 percent of college students pull their hair at some point, although only 1 percent meets the criteria for trichotillomania.
Anemia, malnutrition, and digestive disorders, including bowel obstructions, can develop, if trichotillomania develops into trichotillophagia or eating of the hairs.
Because of this fact, social alienation is common in trichotillomania.
Biological theories for trichotillomania include a neurochemical imbalance, such as a serotonin imbalance.
But for some with trichotillomania, behavioral therapy is more successful when drug therapy helps reduce the urge to pull hair.
But it is increasingly believed that trichotillomania has a biological basis, and thus parents must understand that they did not cause it and that they are not the only parents with a child who has trichotillomania.
Children and adolescents with trichotillomania experience a growing sense of tension or stress just before pulling hair out or when trying to resist hair pulling.
Co-existing psychiatric diagnoses such as anxiety, depression, and addictive disorders are common in trichotillomania.
Compulsive self-mutilation consists of repetitive hair pulling (trichotillomania), nail biting, and skin picking.
Drugs in this class given to treat trichotillomania in children include sertraline (Zoloft), fluvoxamine (Luvox), and clomioramine.
First described in 1889, trichotillomania is a psychiatric disorder, the result of which is alopecia or hair loss, caused by repeated pulling of one's hair from, most often the head, followed by the eyelashes and eye brows.
For many with trichotillomania, hair pulling is not an activity that can be stopped at will.
For some individuals with trichotillomania, certain situations, such as watching TV, lying in bed, or talking on the phone, will trigger the behavior.
Habit reversal training (HRT), a cognitive behavioral therapy, has been successfully used in the treatment of trichotillomania.
Histological examination of hair follicles and skin biopsies also help in the diagnosis of trichotillomania.
Hypnosis has been used in treatment of childhood trichotillomania.
If one SSRI drug is not successful in controlling trichotillomania in a given individual, another drug in this class may work.
Immediately before pulling hair, the individual with trichotillomania feels a mounting tension.
In the areas of hair loss in trichotillomania there will be a mixture of short and longer hairs in the area of hair loss.
It is important that parents to realize that trichotillomania is a complex and not completely understood behavior.
It is important to realize that the occasional or infrequent twisting, pulling, or chewing of hair in a child does not constitute trichotillomania and does not require medical attention.
It is not clear if genetic factors are involved in the development of trichotillomania, although some studies report an increased percentage of relatives with various psychiatric disorders.
Medication to correct biochemical imbalances in the brain is a common component of trichotillomania treatment.
Other approaches to hypnosis in trichotillomania teach the child that he or she has control over events in his or her life, including hair pulling.
Other techniques, consider alternative, used to trichotillomania include biofeedback, yoga, and exercise.
Parents must realize that the earlier the treatment for trichotillomania is begun, the more likely that the hair pulling can be controlled.
Patients in their seventies may suffer from trichotillomania.
Rarely, the individual with trichotillomania may attempt to pull the hairs of others.
Since it is hypothesized that serotonin activity is abnormal in trichotillomania, selective serotonin reuptake inhibitors (SSRIs) are commonly given to improve symptoms.
Since patients are adept at disguising and denying the symptoms of trichotillomania, the condition may go on for years without detection or treatment.
Since those with trichotillomania do not report pain, drugs to decrease pain thresholds have been tried as well.
Since, as of 2004, the actual cause of trichotillomania was not known, there is no known means of prevention.
The act of hair pulling in trichotillomania is often ritualistic.
The clinician may use rating scales to assist in the diagnosis of trichotillomania and to assess the degree to which a patient has trichotillomania.
The diagnosis of trichotillomania is made by history and interview, along with histological examination of the hairs in the area of hair loss as well as skin tissue in the area.
The drug which has been the most successful in treatment of trichotillomania is clomipramine (Anafranil), a tricyclic antidepressant.
The family needs to be a part of therapy since familial stressors may have triggered trichotillomania.
The hair loss associated with trichotillomania is patchy and is characterized by broken hairs of varying length.
The hair pulling in trichotillomania can be differentiated from that in OCD in that the hair pulling in trichotillomania is an impulse behavior where in OCD it is a repetitive act performed as part of an obsession.
The individual with OCD is aware of his or her actions, while the individual with trichotillomania is not always conscious that he or she is pulling hairs.
The individual with trichotillomania will have bald spots on the head or missing eyelashes or eyebrows.
The most common symptom of trichotillomania is hair loss.
The pattern of alopecia in trichotillomania varies among patients and the degree of hair loss will range from a barely noticeable thinning to total loss of hair.
The prevalence of trichotillomania has been estimated to be as high as 2 percent of the general population.
The prognosis is much more difficult for those who develop trichotillomania after age 13.
The psychoanalytic model purports that trichotillomania occurs in an attempt to resolve a childhood trauma, the most common of which is sexual abuse.
The typical trichotillomania patient will spend one to three hours daily pulling hairs.
The urge to pull can be so intense that the individual with trichotillomania cannot think of anything except hair pulling.
There are no FDA drugs which specifically treat trichotillomania.
There is an immense amount of embarrassment and denial associated with trichotillomania.
There is no clear cause of trichotillomania, but there are psychoanalytical, behavioral, or biological theories for this disorder.
There is some debate about whether these people have trichotillomania and about whether these criteria for diagnosis of trichotillomania are too restrictive.
This experience also improves social interaction, as isolation is common among patients with trichotillomania.
Thus, it is important that once trichotillomania is diagnosed that the healthcare provider inquire into any other medical concerns that the patient may have.
Thus, social life and work production often suffer with trichotillomania.
Tics, borderline personality disorders, and OCD are all more prevalent in trichotillomania than in the general population.
Tonsure trichotillomania is a pattern hair loss of the scalp in which hair is present only at the nape and on the outer edge of the scalp.
Traditional treatment for trichotillomania involves psychological or behavioral therapy, or medication.
Trichomalacia or distortion of the hair follicles is often present in trichotillomania.
Trichotillomania is a psychiatric condition in which an individual has an uncontrollable desire to pull out his own body hair.
Trichotillomania is characterized by recurrent pulling out of one's hair to produce noticeable hair loss.
Trichotillomania is generally considered to be a nervous habit and may include the pulling of eyebrows and eyelashes.
Trichotillomania is not the underlying cause of hair pulling if there is a medical reason for the hair loss or if another co-existing psychiatric disorder such as hallucination provokes the hair pulling.
Trichotillomania is recurrent pulling out of hair.
Trichotillomania is the most common cause of hair loss in children.
Trichotillomania usually begins in the preteens but has been reported in children as young as one year old and has been seen first in adults over 50 years old.
Usually, the patient with trichotillomania does not present for treatment until, on average, two years after the hair pulling has begun.
When trichotillomania appears in early childhood, the duration of time during which the child is afflicted, is limited.
When trichotillomania strikes the adolescent it is especially important that the behavior be addressed and treated promptly.