Trichotillomania

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Of all forms of hair loss, Trichotillomania can either be the easiest to treat or the most difficult.  It is not caused by any biological or genetic disorder, rather by the sufferer’s own hand.  The literal translation from Greek actually means “hair pulling madness.”  Trichotillomania is the result of the individual twisting, pulling or manipulating the hair to such an extent that it pulls free from the scalp.  In light of this, hair loss is not permanent, however, if the psychological or behavioral disorder isn’t treated, the hair loss can be continual because the behavior will be ongoing.  Although it is evidenced in loss of hair, the condition is not treated by a dermatologist or general practitioner.  However, having said that, it is first necessary to get a proper diagnosis by a qualified Dermatologist.  Usually the person is then referred for psychological or psychiatric treatment and/or therapy.

Who is most likely to be susceptible to Trichotillomania?

In general, it is safe to say that young children between the ages of seven and fourteen years of age are more apt to present with this form of hair loss.  Based on statistics, children are seven times more likely to manifest this illness than adults.  Adults also can be diagnosed with Trichotillomania but prognosis for a ‘cure’ is much more guarded.  Most often adults who suffer from Trichotillomania first presented when they were children.  There has been no evidence that any race or ethnic group is more susceptible to the illness, nor is gender usually a consideration in infants or very young children.  In teenagers it is predominantly manifested in girls and in adulthood it is most often in women.

Is there a treatment or cure for this illness?

The success rate for treatment and/or cure generally depends on the age of the individual.  Young children (pre-adolescent) have a high success rate for realizing a cure.  It is much more difficult to treat teenagers and by the time the individual reaches adulthood the prognosis for a cure is not good at all.  Again, once diagnosed this disorder is not treated by a dermatologist or general practitioner unless the pulling is so severe that it causes secondary issues such as infections or severe inflammation.

Certain factors make a definitive diagnosis difficult.

While it is common for the individual, especially younger children, to willingly discuss the fact that it is ‘self inflicted,’ there are times when further examination must be undergone.  For instance, there a variation known as sleep-isolated Trichotillomania.  It is difficult to diagnose because the individual is not aware of having pulled out their own hair and in these cases it is common to be misdiagnosed as Alopecia Areata.  At other times the dermatologist might need to take on the role of detective to solve the mystery.  Some individuals are either reluctant to discuss having manipulated their own hair out of their head or they may be totally unaware of it since it can be an involuntary action.  An untrained physician may at first make an inaccurate diagnosis, but will probably ‘catch’ it when treatments for Alopecia Areata are not ‘working.’  At this point the individual will be referred for appropriate therapy.

What to do if you suspect Trichotillomania

Of course if an adult suffers from Trichotillomania, he/she will probably have the presence of mind to realize that it is not a dermatological condition.  In that case they know that they can either try to remedy the situation on their own or seek professional help.  A dermatologist would only be called for if some kind of infection and/or inflammation occurred.  However, if a parent notices that a child is evidencing bald spots or sparse areas of hair, the first thing to do would be to make an appointment with the child’s pediatrician and then start observing.  Many times a parent can help with a proper diagnosis by the time the child gets in to see the doctor.  If it is noticed that the child is tugging at or twisting the hair subconsciously, the pediatrician can then make an accurate referral to a child psychologist or behavioral specialist.

A word of caution.

Since Trichotillomania is not physiological but rather psychological it is important to get qualified help.  The symptoms may or may not be indicative of some bigger issue that is a greater cause for concern.  That is a chance that isn’t worth taking.  If you suspect that your child, adolescent or loved one is suffering from Trichotillomania, it is in their best interest to seek proper medical/psychological help.

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