Key Features of Trichotillomania:
- Hair pulling urges: Individuals with trichotillomania experience intense and irresistible urges to pull out their hair, often resulting in tension or discomfort if the urge is resisted. These urges can vary in intensity and may be triggered by various emotional or situational factors.
- Hair loss and bald patches: Trichotillomania leads to noticeable hair loss, resulting in irregular bald patches on the scalp, eyebrows, eyelashes, or other areas where hair is commonly pulled. The severity of hair loss can vary from mild to extensive, depending on the individual’s hair-pulling habits.
- Sense of tension or pleasure: Hair pulling is often accompanied by a sense of tension or anxiety, which is temporarily relieved upon pulling out the hair. Some individuals also report experiencing pleasure, gratification, or a feeling of satisfaction during the act of hair pulling.
- Attempts to resist or control hair pulling: Many individuals with trichotillomania make efforts to resist or control their hair-pulling behaviors but often struggle to do so successfully. These attempts may be met with a sense of frustration, guilt, or shame, contributing to the distress associated with the disorder.
Diagnostic Criteria for Trichotillomania:
To meet the diagnostic criteria for trichotillomania, the symptoms must cause significant distress or impairment in important areas of functioning, such as work, social interactions, or personal relationships. The following criteria, as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), are used for diagnosis:
- Recurrent hair pulling: The individual engages in recurrent hair pulling, resulting in hair loss.
- Repeated attempts to stop or reduce hair pulling: The person has made persistent efforts to stop or reduce hair pulling without success.
- Distress or impairment: The hair pulling causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- Not due to a medical condition: The hair pulling is not better explained by another medical condition (e.g., a dermatological condition) or a mental disorder (e.g., delusional disorder or body dysmorphic disorder).
It is essential to note that trichotillomania can vary in severity and presentation among individuals. Some may engage in hair pulling consciously, while others may do it unconsciously, making diagnosis and treatment complex. Seeking professional help from mental health professionals experienced in treating trichotillomania can provide accurate assessment, diagnosis, and effective management strategies.
Understanding the key features and diagnostic criteria of trichotillomania is a crucial step toward recognizing and addressing this hair-pulling disorder. By raising awareness and promoting education about trichotillomania, we can contribute to a greater understanding and support for individuals living with this condition.
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IAT-Certified Clinical Trichologist
Clare Devereux
Clare is the founding clinical trichologist at Hair Health Essentials, practising in Dublin and London. With over a decade of clinical trichology experience underpinned by a lifetime in professional hair and scalp care, she specialises in personalised diagnostics — from trichoscopy and blood biomarker analysis to genetic testing — to identify what’s really happening with your hair and scalp.
Clinics: Blackrock, Dublin · Eden One, Dublin · Harley Street, London
Hair Health Essentials provides specialist trichological guidance. This content is for informational purposes and does not constitute medical advice. If you have concerns about your health, please consult your GP or medical practitioner.






















