This page is for general education and is not medical advice. It is not a substitute for diagnosis or treatment by a qualified professional. If this is an emergency, call 911 or 988.
Trichotillomania, or hair-pulling disorder, is a body-focused repetitive behavior in which a person repeatedly pulls out their own hair — from the scalp, eyebrows, eyelashes, or elsewhere — leading to noticeable hair loss. People typically try, over and over, to stop and cannot. It is a recognized condition on the obsessive-compulsive spectrum, not a bad habit or a lack of discipline, and it is treatable.
Key facts
- It is one of the body-focused repetitive behaviors (BFRBs), alongside skin-picking (IOCDF).
- The pulling is recurrent and hard to control, with repeated unsuccessful attempts to stop.
- It often begins around late childhood or early adolescence, though it can start at any age.
- Pulling may be automatic (during reading or watching TV) or focused (in response to an urge or feeling), and it is treatable.
What it is
In trichotillomania, hair-pulling moves beyond an occasional behavior into something repetitive and distressing. Many people feel a buildup of tension or an urge beforehand and a sense of relief or release while pulling, followed by regret. The hair loss can lead to shame, time spent camouflaging, and avoidance of situations like haircuts, swimming, or windy days.
Symptoms
- Recurrent pulling out of one’s hair, resulting in hair loss
- Repeated attempts to decrease or stop pulling without success
- Tension or an urge before pulling, and relief or gratification during it
- Distress, or interference with work, school, or social life
- Hiding hair loss with makeup, hats, scarves, or hairstyles, or avoiding situations where it might show
Causes
There is no single cause. Trichotillomania appears to involve genetics and family history of BFRBs or obsessive-compulsive conditions, brain processes linked to habit and reward, temperament, and emotional triggers such as stress, anxiety, or boredom. For many people the pulling regulates uncomfortable feelings or under-stimulation, which is part of why it is hard to stop.
How it is treated
The most established treatment is a behavioral therapy called habit reversal training, usually delivered within cognitive behavioral therapy (CBT) or exposure and response prevention (ERP). It helps you identify triggers, interrupt the behavior, and replace it with a competing action, while building awareness and coping skills. Some people also benefit from medication. Treatment is practical, and meaningful improvement is realistic.
From our clinical review. Almost everyone who tells me about their hair-pulling has been hiding it for years, sure they are the only one. They are not — it is far more common than people realize, and it has a real, skills-based treatment. Naming it out loud, without shame, is usually the hardest and most freeing step.
If hair-pulling is costing you time, confidence, or peace of mind, effective help is available. Learn about ERP and CBT, find counseling and low-cost options with Find Help by State, or talk to someone about what you are going through.
Frequently asked questions
What is trichotillomania?
Trichotillomania, or hair-pulling disorder, is a body-focused repetitive behavior in which a person repeatedly pulls out their own hair — from the scalp, eyebrows, eyelashes, or elsewhere — causing noticeable hair loss. People usually try to stop and find it very hard to control.
Why can't I just stop pulling my hair?
Hair-pulling is more than a habit. It can become automatic or soothing and is genuinely difficult to control, which is why willpower alone rarely works. It is a recognized condition on the obsessive-compulsive spectrum, not a character flaw, and structured treatment helps.
How is trichotillomania treated?
The most established treatment is a behavioral therapy called habit reversal training, often within CBT. It helps you notice triggers, interrupt pulling, and substitute a competing action. Some people also benefit from medication. A professional can tailor the plan.
Sources
- Trichotillomania — MedlinePlus, U.S. National Library of Medicine
- Body-Focused Repetitive Behaviors (BFRBs) — International OCD Foundation (IOCDF)
- OC Related Disorders — International OCD Foundation (IOCDF)
Reviewed against the sources above. This page is educational and is not medical advice.