Trichotillomania & Excoriation Disorder
Definition

Trichotillomania is a disorder in which the individual compulsively and repeatedly pulls out his/ her own hair, often resulting in observable hair loss.

Common places from which individuals pull include: eye brows, eye lashes, scalp, and face, although any place on the body that hair grows can become a pulling site (arms, legs, pubic area, chest, etc.).

Symptoms

The diagnostic criteria currently state that Trichotillomania episodes are preceded by a high level of tension and a strong "urge" to pull hair which, upon completion, results in a sensation of relief or pleasure. Recent data, however, suggests that many individuals who suffer from Trichotillomania do not report experiencing such a tension/relief component to pulling.

At times, hair pulling is done as a conscious behavior. More frequently, though, it is done as an unconscious habit. Typically done alone, hair pulling may occur while watching TV, reading, talking on the phone, or driving. The pulling episode is not necessarily a reaction to stress and can just as easily occur when the individual is in a calm, relaxed state.

Trichotillomania sufferers often camouflage the results of their hair pulling by using hats, scarves, long-sleeve shirts, and false eyelashes.

Prevalence

Estimates indicate that Trichotillomania may affect as much as 4% of the population and symptoms usually begin before age 17. Women are four times more likely to suffer from Trichotillomania than men.

Treatment

Cognitive Behavioral Therapy (CBT), Habit Reversal Training (HRT) and Stimulus Control are often effective modes of treatment. With these modes of therapy, the individual is exposed to the triggering factors of hair pulling while learning skills to refocus those urges on to a different activity.

Skin Picking

Excoriation disorder is the repetitive picking at one's own skin to the extent of causing damage. It is very similar in nature to Trichotillomania and most often involves the face, though it may involve any part of the body. The compulsive picking may focus on actual or imagined skin variations or defects.