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Conditions

Hair restoration · Hair-loss diagnosis and restoration

Trichotillomania

Understand recurrent, hard-to-control urges to pull out hair.

Editorial publication · Medical review pending.

Understand

Trichotillomania is a disorder involving repeated urges to pull out hair and difficulty resisting despite resulting hair loss and distress.

Possible symptoms

Irregular patches contain hairs of different lengths; rising tension before pulling and relief afterwards are common, with possible shame or isolation.

Causes and associated factors

The cause is not fully understood; stress, anxiety, automatic habits, family factors and mechanisms related to obsessive-compulsive disorders may contribute.

Diagnosis

A clinician explores pulling, triggers, impact and any swallowing of hair while excluding a scalp disease.

Tests

Examination is often sufficient; dermoscopy or biopsy can distinguish another alopecia, and gastrointestinal tests are needed when swallowed hair causes symptoms.

Course of the condition

The disorder may fluctuate and become chronic without care; hair often regrows if follicles have not been permanently damaged.

Care options

Cognitive behavioural therapy with habit-reversal training is a central treatment; transplantation does not treat the urge and is considered only after durable control.

When to consult

Seek help if you or your child pull hair, patches appear, or hair is chewed or swallowed.

Urgent help

Severe abdominal pain, persistent vomiting, a swollen abdomen, inability to eat, suicidal thoughts or risk of self-harm needs urgent help.

Questions for your doctor

  • What is causing my hair loss?
  • Are the follicles still active or already scarred?
  • Which medical treatments should be tried or stabilised before a transplant?
  • Can my donor area support a realistic and lasting result?
  • Which scalp signs need prompt medical care?

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A procedure linked to a condition does not establish an indication for your individual situation.

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