Woman pulling at hair

Shining a light on trichotillomania: the compulsion to pull out your own hair

For many women, the idea of moulting in the shower is worthy of a sad face emoji, and we’ve probably all experienced the trauma of an over-plucked eyebrow at least once in our lives. But imagine developing bald patches across your head, or losing your eyelashes or your eyebrows altogether. Not because of any nasty disease, but because you just can't stop pulling your own hair out. If you're a nail biter then you'll probably understand just how this happens: no matter how many times your mum tells you to get your fingers out of your mouth, somehow, they always end up back there again.

"Trichotillomania" is the name given to the compulsion to pull out your own hair, whether it's from the head, the eyebrows, eyelashes, beard, chest or even genitals. And while you may never have heard of it, according to the TLC Foundation for Body-Focused Repetitive Behaviours, who provide treatment, information, education, and support for those affected by the condition, it is believed to affect up to two in every 50 adults worldwide. In the US alone, an estimated 2.5 million people suffer from this condition at some point during their lives. And while these may seem like high figures, it is still considered to be a hugely under-diagnosed condition.

Different from simply picking at split ends, trichotillomania is diagnosed, in part, according to a criteria of a growing urge to pull out the hair and a building of tension before pulling, coupled with a sense of relief once the hair is removed. The condition is believed to be closely related to stress and anxiety issues, and to obsessive compulsive disorder. Many people also pull at their hair unconsciously, making it even more difficult to treat through willpower alone.

Although trichotillomania is around four times more common in women, either gender can be affected; it is predominantly found in teenagers and young adults, having started in childhood. Like the split end snipping that your hairdresser tells you off for, it often begins as an innocuous habit: “It is normally a benign and pleasant habit, but something triggers it to become serious, leading to trichotillomania. Not only is it more common in women, but it occurs mostly around puberty and menopause,” trichologist Philip Kingsley told Get The Gloss.

If you need proof of just how common the condition actually is, there are a number of famous faces who have all spoken out about their own experiences with trichotillomania, including Megan Fox, Justin Timberlake and Charlize Theron. Actress Olivia Munn opened up about her own compulsion to pull at her eyelashes in an interview with the New York Daily News, commenting: “It doesn't hurt, but it's really annoying. Every time I run out of the house, I have to stop and pick up a whole set of fake eyelashes."

Olivia Munn in front of a dressing table making peace sign Credit: Twitter/ @oliviamunn

As with many health conditions, the symptoms can range from person to person, but they are - unsurprisingly - all characterised by hair loss. Although this may appear minimal at first, it can lead to bald patches, bare eyebrows and missing eyelashes. In the long term, many sufferers also experience depression and social isolation, often caused by living with these side-effects: “I used to avoid certain social situations because of trich, severely lacked confidence, and every time I left the house would be filled with the utmost dread that someone (even a stranger) would notice that I didn't have eyelashes,” explained blogger Pretty and Polished. It is estimated that 20 per cent of individuals with trichotillomania also develop a more complicated and developed version of the condition called trichophagia - otherwise known as Rapunzel syndrome - where they chew, and even ingest, their own hair.

Of course, not everyone has the luxury of being able to afford movie star hair treatments, or even to be able to pick up a pair of falsies every time they need to. So what can be done to help people living with this condition day-to-day? The first line of attack prescribed by doctors is usually a method of cognitive behavioural therapy known as habit reversal training, where sufferers are encouraged to keep note of their triggers and take on diversion techniques, such as squeezing a stress ball.

But it’s true that CBT takes time to make its effects felt, so on a day-to-day basis, those with trichotillomania often disguise their condition using wigs, hairstyles, scarves, make-up and clothing. Some women have also turned to tattooing or microblading - where small individual strokes are drawn with a special pen to mimic the effects of real hairs - in order to fill in their eyebrows. In order to prevent further pulling, sufferers have reported putting on gloves, wearing false nails or applying hand cream, all of which reduce grip and make the process harder and more conscious, or shaving their heads altogether.

Those in the medical profession freely admit that more research needs to be done to shed more light on what causes this condition and how to treat it. In the meantime, all we can do is accept that everyone has their own ways of coping with stress - some people go for a run, some people eat an entire tub of Ben and Jerry’s, some people, consciously or not, pull out their own hair.