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What Is Trichotillomania? When Your Hair Obsession Gets Out of Hand

Emma Goddard
by Emma Goddard Published on February 23, 2015
146 shares

Last night around 11 p.m. I hung up the phone after a chat with my boyfriend and told myself to get ready for bed. About 15 minutes later, when my phone buzzed with a text, I realized that not only had I not moved from that same position on my bed, but I had also spent that entire time picking away at my hair. Moments like this one have occured over the past eight years, and while I've never been diagnosed, I often wonder if my odd hair obsession is a sign of trichotillomania.

For those of you who may be unfamiliar with trich, it's characterized as an impulse control disorder which involves the constant urge to pull out hair from various parts of your body and at times ingest it.

However, trich isn't a "narrow field," according to Dr. David Kingsley, Ph.D., president of the World Trichology Society, trichologist, and co-owner of the British Science Corporation. Rather, while you may often hear of extreme cases of trich where people pull out all of their hair, there are also more minor cases as well. With the disorder mainly occurring in women and typically beginning around puberty, Dr. Kingsley said that whether just constantly twirling and smoothing out your hair, or going as far as picking your hair out at the scalp, there are many forms of trich. In fact, it's reportedly one of the hardest habits to break.

"People find it as a comfort; people do it to relax," Dr. Kingsley said. "Stopping it is one of the most difficult things. The literature also says, in my experience, it’s more difficult to stop trichotillomania than it is to give up smoking. And if [those with trichotillomania] don’t admit to it, when it’s associated with bulimia or anorexia, particularly bulimia, the person would admit to that sooner than admitting to pulling their hair out. It’s quite deep-rooted in the psyche."

With that said, Dr. Kingsley also noted how trich isn't always easily defined.

"There's eating hair, theres eating the hair bulb, which is like the root of the hair," Dr. Kingsley said. "There’s just twirling it and pulling, which a lot of people do, there’s plucking it out with either fingers or little forceps, all the way to literally plucking every hair on the body like pubic hair, armpit hair, scalp hair. So it does run the whole gauntlet."

So basically, it's not as easy as simply saying that just because you twirl your hair you must have trich. After all, a lot of women twirl their hair. At the same time, just because you don't have bald patches on your head doesn't mean you don't have it either.

"I suppose it’s where you put the definition," Dr. Kingsley says. "Is playing with your hair a form of trichotillomania? Some people would argue it is, even though they’re not actually pulling their hair out. A lot of women play with their hair but they wouldn’t be diagnosed with trichotillomania, but I think if it turns into a habit that you can’t break easily then I think it starts becoming a bit more of a problem. Once it starts affecting their life and their lifestyle, and they’re starting to hide things and people are starting to notice, that’s when things are starting to escalate."

So now you're probably wondering how all of this applies to me and picking at my split ends. Well, this horrible habit of mine began when I was a freshman in high school. I was sitting in the back seat of a friend's car one day, listening to her as she discussed her split ends with her mother — a pretty typical conversation for a teen girl. At the time however, though I generally knew what a split end was, I had never actually seen one let alone looked at my own. So it intrigued me as I watched this girl as she methodically picked up different locks of her hair, twirled them in her hands and broke off all those dead ends. Soon enough, after this encounter, I was doing it too.

OK, what's the big deal? Everyone does it. Bored girls on the subway do it, guys with hair long enough to pull into man buns probably do it, and anyone who's ever used a curling iron to fry their hair to a crisp has definitely done it. Picking at split ends isn't something I started and not everyone who picks their split ends has trich either.

However, for me, this little habit progressed into something a lot worse. Basically, picking my split ends isn't just something I occasionally do when I'm zoning out or bored. In college I would sometimes spend 30 minutes playing with my hair just to look up at the clock and realize that I should’ve been studying. In high school, I spent part of my SAT breaking my ends off. The need to pull at my hair has kind of become an addiction.

I wouldn't say I'm an extreme case by any means — that is, if someone would even diagnose me with trich — and it hasn't moved to other parts of my body like it does for others, but it's still made quite the impact on my life.

For starters, my habit has gotten so unhealthy that many of my loved ones have called me out for it. I can't even tell you the number of times people have swatted at my hands when they've caught me in the act. Even worse, I usually just continue pulling apart my ends when they aren’t paying attention. When it gets really bad, I force myself to put my hair into a bun so I won't touch it.

Sometimes my hair picking sessions will last so long that, when I'm finally done, I notice the hairs I've broken off all over my clothing. You know when you get a fresh haircut and find little pieces of hair all over you when you leave the salon? It's like that.

Other times, full strands of my hair fall out if I'm not being gentle during the "process." So if it’s not already obvious, my hair has significantly thinned out throughout the years. What once used to be thick and voluminous has now become thin and flat. In fact, while I wouldn't call it a bald spot exactly, I have one of those deep parts on the pack of my head so much so that I've learned how to efficiently hide it with the hair that's still there. This isn't exactly out of the ordinary because a lot of men and women just happen to have naturally deep parts, but I can assure you that I didn't have one eight years ago.

To clarify, this isn't something that I do because it's fun. I actually feel guilty when I realize what I've done, and I often make myself look at the back of my head in a mirror as a reminder of my hair loss thus far. I don't pick because I want to do it, but because some part of me needs to do it. Not to mention, it's usually pretty mindless and I don't realize how long I've been going at it until I snap out of whatever trance I'm in.

A sense of shame

"I think there's a lot of shame in it," Dr. Kingsley said, discussing why trich is something many don't open up about. "I think hair loss in general, let’s forget about how the hair is falling out, but hair loss in general particularly for women is a very sensitive subject. Their hair is part of their persona. You see all these magazines [about] how luxurious hair is; it’s sexy, and vibrant and young. I think it’s possible that it’s a little bit rooted in that area."

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How to cure trich​otillomania

Although there isn't necessarily a cure for trich, those who think they might have it can go see a trichologist to determine how they can make changes to break the habit and how to be more aware of what they're doing with their hands.

"You look at the area and it’s not generalized hair loss," Dr. Kingsley said. "It’s not falling out from the scalp because of the nutrition, or stress, or genetic factors. It’s being broken and the breakage is fairly uneven."

​As Dr. Kingsley noted in our conversation, even something as simple as using a stress ball might help prevent people from touching their hair. For instance, when I admitted to him that when I usually use my spare hand to pick at my split ends when I'm on the phone with people, he responded that having something to squeeze in place of my hair could help me.

Likewise, for individuals who feel the need to touch their scalp, there are topical solutions and creams that can make that itchy or sensitive sensation go away, curbing the urge. However, while many trich patients see a trichologist when they begin to experience bald patches, those who have actually picked every single hair out of their head typically see a psychiatrist at that point, according to Dr. Kingsley. In the end, the way people break the cycle is different with each situation.

The reason why I'm sharing this with everyone, despite being uncomfortable talking about it, is because there are more people than you know struggling with trich out there. It's one of those things that few individuals want to talk about because they don’t want to feel like outcasts. For those people, the disorder is so prevalent that it affects their daily activities, health and social lives.

Imagine what it would feel like being unable to stop touching your hair for hours on end. You stop for a second only to immediately pick up that strand of hair again, and again, and again. You watch as more of your hair falls out knowing it's only going to make things worse but you just can't bring yourself to do it. Trich isn't something you can just stop. So if you know someone who has it, be supportive; they’re trying their best to quit.

Would you like to share your personal story about trich with us? Tweet us @wewomenUSA!

This article was written by Emma Goddard. Follow her on Twitter @egoddardhokie.

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