Trichotillomania

Trichotillomania is a disorder characterized by individuals repeatedly plucking hairs from their scalp or other hair-bearing areas. This repetitive body-focused behavior is often associated with skin and nail picking and is considered part of the obsessive-compulsive disorder spectrum, as classified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The exact cause of trichotillomania remains unclear, but genetic factors may play a role. It is commonly seen in patients who also have obsessive-compulsive disorder, mood disorders, and generalized anxiety. The condition is most prevalent in children and adolescents, but adults can also be affected.

Patients with trichotillomania may present with hair loss in various areas of the body, with the scalp and eyebrows being the most commonly involved. The affected areas often have an angulated or irregular shape, and hair shafts may be of different lengths due to chronic pulling and breaking. Some individuals might even consume the hair they pull out (trichophagy), potentially leading to the formation of a hairball (trichobezoar) in the stomach.
For patients who recognize their behavior, collaborating with a mental health professional can help reverse the habit. Pharmacological treatment may also be beneficial in some cases, often in combination with behavioral therapy. In general, this type of hair loss is reversible if the behavior is modified.