Trichotillomania is a condition where a person feels compelled to pull their hair out, often resulting in patches of baldness, after which there is usually a sense of relief or an easing of pressure. Cases of trich, as it is sometimes abbreviated to, range from mild (where a concentrated effort not to pull is sufficient to stop the act) to severe, where the disorder becomes all-consuming and has a disruptive impact on daily life. It also impacts on your hair follicles. The repeated pulling out of hair can damage the follicles, affecting how the hair regrows. It can grow slower and more sparsely, but the hair texture and colour can change as well. Often hair will grow back coarser, more kinky or grey in colour. The cyclical nature of trichotillomania means that this change to colour and texture can increase the sufferer's desire to pull out these new hairs. It is not possible to say definitively that trichotillomania causes irreversible damage to the hair follicles, leading to permanent baldness. Most sufferers will see some if not full regrowth. Early treatment is key though. 1 It’s not as rare as you would think. For a condition that is rarely talked about and few people are aware of, you may be surprised to learn that 4 in every 100 people have trichotillomania. It affects people of all ethnicities, nationalities and socio-economic backgrounds. It affects both adults and children, although the most common age group for the onset of symptoms is 11 to 13 years. In children, it is not gender specific, with generally equal numbers of boys and girls affected; however, in adulthood, the vast majority of people with trich tend to be women. 2 It’s not just hair from your head. If you have trichotillomania, you may be driven to pull clumps of hair from your scalp but you may also feel compelled to pull hair from your legs, chest, armpits, beard, pubic hair, eyelashes, eyebrows – or indeed any hair from your body. 3 The cause remains a mystery. Trichotillomania is a neurological disorder that creates an intense urge to pull one’s own hair out and the tension grows until that urge is satisfied – but the cause of it is not known. Some experts theorise it is an addiction, others that it is a result of stress and anxiety, or, in some cases, a form of self-harm. 4 Treatments range from hypnosis to ‘fiddle jewellery’. There has been little medical research into the causes and treatments of trichotillomania but the most effective approach tends to be combining behavioural therapy (in the form of psychotherapy, CBT or hypnosis, for example) with a network of emotional support. Some people benefit from distraction techniques in the form of specially designed bracelets CBT, or as it is known in full, Cognitive Behaviour Therapy, works by identifying and then changing the patterns that lead to hair pulling. It is usually a combination of coaching, group therapy, stress management training, relaxation teaching and working on problem solving. Group therapy can be particularly effective as a sense of community and a knowledge that you're not alone can be a powerful healing tool for those suffering from trichotillomania. 5 There IS support out there. For some trich sufferers who have spent years feeling a range of emotions from shame and guilt to acute self-consciousness and loneliness, social media has transformed the landscape. While public awareness and medical research has a lot of ground to make up, there is a great deal of support in the form of blogs, vlogs and online support networks. For advice and support on dealing with trichotillomania, the Trichotillomania Learning Centre [click here] is an invaluable online resource. Similar UK websites include Trichotillomania Support [click here].