Trichotillomania Explained

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What is Trichotillomania?

Trichotillomania is a body-focussed repetitive behaviour.

People with Trichotillomania (often referred to as Trich or TTM), have an irresistible urge to pull out their hair, usually from their scalp, eyelashes, and eyebrows. It is often caused by negative emotions such as stress, anxiety, or boredom, but may also have no obvious emotional cause. Many people develop Trich when they are teenagers or young adults. The urge to pull the hair can be overwhelming, or it can be something which is done subconsciously. This makes it an extremely frustrating and depressing condition, affecting confidence, wellbeing and self-esteem.

Our bespoke and versatile solution

Our Enhancer System can be highly effective for women struggling with compulsive hair pulling, because it helps to reduce the urge to pull hair, can protect new hair while it grows and get you back to a positive way of life. The Enhancer solution uses a combination of hair extensions and a scalp mesh to create a solution to your hair loss from Trichotillomania.

It works on complete hair loss as well as partial hair loss to increase the natural look of the remaining hair. The Enhancer System can be combined with a form of behaviour therapy called reversal training. Many clients say that the Enhancer System has played a part in breaking the cycle of pulling and has been the hair loss treatment they were searching for.

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Smiley Client looks in mirror at new hair Close up on blonde female with Trichotillomania having wefts attached Strawberry blonde hair integration system

In Rebekah's Words

A client for 11 years, Rebekah has kindly allowed us to share some of her thoughts about the condition that causes her hair loss.

“Trichotillomania is the hardest thing to explain to people, why would you pull your hair out? When I was 19 my close friends had noticed my hair and started to question me about it, so I told them the truth.

People take for granted going to the hairdresser, I would be a little bit jealous sometimes and think why me? But having the system means you get back that little bit of femininity.

I love having my system done, the whole process makes me feel confident.”

Read Her Story
Trichotillomania client having hair system applied Trichotillomania client having hair system blow dried
Smiling client with strawberry blonde hair

Trichotillomania Symptoms

People with trich feel an intense urge to pull their hair out and they experience growing tension until they do. After pulling their hair out, they can feel a sense of relief. A person may sometimes pull their hair out in response to a stressful situation, or it may be done without really thinking about it. Most people with trich pull out hair from their scalp, but also other areas including eyebrow and eyelashes.

Bald patches left on the head tend to have an unusual shape and may affect one side more than the other. Trich may cause feelings of shame and low self-esteem. Those affected may try to keep their condition to themselves. People who suffer from Trichotillomania often say that their condition is not understood by those close to them, nor by doctors and this can heighten the feelings of isolation and anxiety.

Trichotillomania Causes

It’s not entirely clear what causes trich. It could be:

  • your way of dealing with stress or anxiety
  • a chemical imbalance in the brain, similar to obsessive compulsive disorder (OCD)
  • changes in hormone levels during puberty
  • For some people, hair pulling can be a type of addiction. The more they pull their hair out, the more they want to keep doing it. (NHS Choices)

Why is it so hard to stop hair pulling?

Trichotillomania is one of a group of disorders called body-focussed repetitive behaviours (BFRBs). This group also includes dermatillomania (skin-picking disorder) and onychophagia (nail biting). People with BFRBs are unable to stop themselves from performing the behaviour, despite wanting to stop.
For many people, trichotillomania can be a chronic condition. Pulling can act as a method of self-soothing and self-regulation, making it a difficult behaviour to part from. Many also pull out their hair completely subconsciously, making it even more difficult to stop. Additionally, it is common for hair-pullers to engage in a ritual while pulling, such as feeling for hairs of certain texture, colour or length, examining, biting, and rubbing the root of the hair along their lips, discarding the hair, or swallowing it (trichophagia).

For some, it may seem that trichotillomania is a disorder that they will never be able to overcome. However, there are treatment options available, such as Cognitive Behavioural Therapy (CBT), Habit Reversal Training, Comprehensive Behavioural (ComB) Treatment, and Acceptance and Commitment Therapy (ACT).

There are also numerous free resources, such as online and in-person support groups, the TLC Foundation for BFRBs ( and online forums.

Thank you to our client, Caroline Harbison, who has very kindly helped our Team to edit this page based on the most recent research in to Trich and bringing her own detailed knowledge of the condition. You can read more about Caroline’s Story here.

In Laura's Words

“I love having my hair system but at 37 I’ve realised that it’s ok to be female and bald as well! Trichotillomania isn’t something I chose to have but being open about it and accepting it was the best thing I ever did.

Wearing a hair system has made my life more enjoyable. It’s so nice to get up in the morning and go out how you are. I’ve got more confidence and I can focus on things other than hair!“

Laura is a client at Hair Solved Bristol.

Read Her Story
female client shows bare pacthes caused by trichotillomania Smiling Client With Trichotillomania wears Enhancer System while swimming and no longer worries about getting hair wet