What Is Hair-Pulling Disorder, And How Can It Affect Your Life?

Medically reviewed by Laura Angers Maddox, NCC, LPC
Updated April 16, 2024by BetterHelp Editorial Team

If you experience hair-pulling disorder, you likely already know that it can affect your life significantly, whether by making it difficult to interact with others or feel in control of your behavior. Because this disorder can be connected to other mental health conditions, particularly obsessive-compulsive disorder (OCD), hair-pulling disorder is more than a bad habit and can be challenging to manage on your own. 

In many cases, the compulsion to pull hair can be so strong that it interferes with daily functioning. For example, some individual may pull their hair automatically in response to stress or other stimuli. 

With the right support, though, it can be possible for people who pull out their hair to find relief from symptoms of hair-pulling disorder and become a more confident, happier version of yourself. Online therapy may be one way to get the professional help you deserve.

You can overcome hair-pulling disorder

What is hair-pulling disorder?

Hair-pulling disorder, often known formally as trichotillomania, is a mental health disorder that usually involves recurrent, intense urges to pull hair from your scalp, eyebrows, or other parts of the body. Those experiencing hair-pulling disorder often find it difficult or even impossible to resist the overwhelming impulse to pull their hair, even if they want to.

Someone with trichotillomania may try to stop pulling their hair, but the compulsions and impulses are often too strong to ignore. It's estimated that less than 2% of people live with this disorder, which may be why many people aren’t aware of trichotillomania until they experience it firsthand.

Though it is generally focused on pulling hair out from the scalp, eyebrows, or eyelids, trichotillomania can cause irresistible urges to pull of any kind of body hair. It's often important to watch for the signs and symptoms of this disorder because it may lead to serious consequences if left untreated for too long. Excessive hair-pulling can result in baldness, which may cause significant emotional distress and interfere with an individual’s ability to function.

As a result, many people with trichotillomania may go to significant lengths to disguise their hair loss and other symptoms of the disorder, such as wearing false eyelashes or wigs, which can be a stressful and isolating experience.

Hair loss and other symptoms of hair-pulling disorder

Perhaps the most obvious sign of hair-pulling disorder can be the repeated pulling of hair itself. Those with the disorder may pick at their eyebrows, eyelashes, scalp, or their pubic hair often. Also notable in many cases can be hair loss and bald spots that may appear in these areas. 

As mentioned, someone living with trichotillomania may dedicate a lot of effort to trying to hide their behavior. They may feel an increasing sense of guilt or shame that motivates them to withdraw from others, a tendency that can exacerbate symptoms. The urge to cover up unusual-shaped bald patches, and hair-pulling habits, in general, might lead someone living with hair-pulling disorder to turn to potentially unhealthy coping mechanisms that can affect their well-being, like excessive substance use, or lead to the development of skin conditions or other mental health disorders. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Understanding the intensity of the urges that can come with trichotillomania may be a key part of differentiating it from other mental health disorder symptoms. Typically, an individual may feel frustrated, tense, or overwhelming anxiety right before they engage in the behavior, which may trigger trichotillomania the longer they try to resist the impulse. 

As soon as they pull the hair, they might associate the action with positive feelings or pleasure that can seem intensely rewarding, though it’s often short-lived. This pattern is often cyclical, and the impulse to pull hair again may return soon after relief is found.

Other behaviors involving hair may also be commonplace for those experiencing this disorder. They may play with their hair after they pull it out, eat it, examine it, chew on it, or engage in any number of other activities involving the hair. Eating hair can lead to serious health concerns, such as weight loss or hairballs forming in the digestive tract that may need to be surgically removed.

By watching for any of these types of behaviors, it can be possible to encourage someone with this disorder to seek the help they may need to manage symptoms. 


Who has hair-pulling disorder?

While hair-pulling disorder often manifests anywhere between early childhood to early teens, any age can it. It can be common for it to run in families, which generally means that if someone in your immediate family has the disorder, you may have a higher likelihood of developing it yourself. Knowing your risk may help you keep an eye out for symptoms and learn to identify them in others who are close to you.

Obsessive-compulsive disorder

Additionally, those with obsessive-compulsive disorder (OCD) may experience trichotillomania as a manifestation of its symptoms. Because it's usually considered an impulse control disorder, trichotillomania can be tied to the anxiety that may occur because of OCD or similar mental health disorders. If you’re living with OCD, an anxiety disorder, or another condition that may produce heightened feelings of anxiety, it's possible that trichotillomania could be connected to it. 

Because of this, it can be important to watch for symptoms that don't fit with other disorders you've been diagnosed with so you can be diagnosed properly.

Body-focused repetitive behaviors

Finally, those who experience high amounts of stress, even in the absence of a mental health diagnosis, may be susceptible to this disorder. For many who live with it, trichotillomania usually acts as a stress reliever. They may pull at their hair while watching TV or whenever they feel anxious. Pulling hair can feel like a way to express and let go of pent-up stress in the body. Though it may temporarily relieve tension and offer an outlet for stress, this sort of behavior can quickly and easily spiral out of an individual’s control.  

Getting help for hair-pulling disorder

If you or someone you know show signs of hair-pulling disorder, it can be beneficial to speak with both a physician and a licensed mental health professional. Seeking a medical opinion or physical exam can help you make sure that the symptoms you're experiencing aren't the result of an underlying medical condition or the side effects of a medication you're taking. 

Meanwhile, a mental health professional can help you understand what might be driving you to pull your hair, what you can do to halt the behavior, and other solutions that can address underlying emotions in a healthier way. They use methods such as cognitive behavioral therapy where mindfulness-based practices such as deep breathing or using stress balls can help replace the negative behavior with a positive one.

Another exercise called habit reversal training has also been an effective way to treat TTM. It uses four components to help people refrain from impulsive habits:

  • Mindfully and verbally describe pulling your hair in a mirror any time you engage in the behavior

  • Having your therapist point out when you pull your hair until you’re able to recognize the patterns on your own

  • Learning what triggers lead to pulling your hair, such as urges, thoughts, or experiencing stress or frustration

  • Identifying the situations that may cause you to pull your hair to prepare yourself for any urges that may arise

Because hair-pulling disorder is normally considered a type of impulse control disorder and often coincides with other mental health disorders, including obsessive-compulsive disorder (OCD), it may be difficult to manage symptoms on your own. Resources that make receiving care and support more convenient may be useful, especially if you’re not comfortable navigating traditional in-person treatment options. 

Online therapy may empower you to connect with a professional without leaving the comfort of your own home. It can also enable you to choose between a phone call and an online chat if you don’t feel comfortable with the video call format.

Current research suggests that online therapy can be just as effective as in-person therapy for treating symptoms of a variety of mental health disorders. A 2022 study investigated the efficacy of online therapy for treating trichotillomania and skin-picking disorder and found that it could be an effective and acceptable form of treatment.

You can overcome hair-pulling disorder


Hair-pulling disorder, or trichotillomania, is a mental health disorder usually characterized by excessive and oftentimes uncontrollable pulling of the hair on the face, scalp, or body. Though its symptoms can be challenging to manage and may require professional intervention, it can be possible to take control of the urge to pull. Seeking out the guidance of a therapist and a physician, if necessary, can set you on a path toward success.
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