Trichotillomania (hair-pulling disorder)
If you pull your hair and find it difficult to stop, you may have spent a long time trying to manage it quietly. Here you can understand the pattern, learn about support and find words for a professional conversation.
A pattern that deserves understanding, not blame.
Trichotillomania involves repeated hair pulling that causes hair loss, with attempts to reduce or stop and distress or disruption to life. A professional also considers other causes of hair loss.
Pulling may happen with a strong urge or without much awareness. Your pattern can vary by situation; you do not have to fit one description to talk about it.
Based on NHS · International OCD Foundation
What happens around the pulling?
- The situation
What you are doing and where you are
- Awareness & sensations
What you notice before or only afterward
- The pulling
The behavior you want help understanding
- The effect
Physical effects, distress and daily impact
Sometimes focused. Sometimes barely noticed.
You might notice an urge before pulling, or become aware only afterward. Assessment can look at different situations and what is happening around them.
Noticing a pattern is a way to inform care, not a reason to blame yourself for every occurrence. Discuss observations with a professional rather than treating them as a test result.
Based on International OCD Foundation · International OCD Foundation
What you might recognize around pulling.
These examples can help you describe what happens, rather than establish a diagnosis.
Urges & sensations
An urge to pull, or attention drawn to the feel of particular hairs.
Automatic moments
Noticing you have been pulling while concentrating on something else.
Changing the pattern
Finding it difficult to reduce pulling despite wanting to, sometimes with relief afterward.
The effects
Hair loss, distress or avoiding situations because you are worried about pulling being noticed.
Based on NHS · International OCD Foundation
You can talk about pulling without being blamed.
Hair pulling can happen with different levels of awareness and in different situations. A person may notice an urge, or only realize later that pulling has happened. These descriptions help a professional understand the pattern; they are not separate diagnoses to choose between.
In a fictional example, Kit notices pulling while concentrating at a desk and feels embarrassed about asking for help. Kit can begin with the effect on the day and the wish for support, rather than proving enough hair loss to deserve an appointment.
Fictional examples to explain an experience. They are not a checklist or a diagnosis.
Based on NHS · International OCD Foundation
Discuss the behavior and your health together.
A doctor can ask about pulling, examine hair loss and consider skin or other medical causes. Tell them about any hair eating as well as pulling.
A useful example includes when you notice pulling and what it changes for you. You can ask about a therapist familiar with body-focused repetitive behaviors and whether a severity measure would help in your care.
Based on NHS · International OCD Foundation
- 1What has changed?
One example from a recent day.
- 2When do you notice it?
When it began and how often it happens.
- 3What feels harder?
The effect on your life and what you want help with.
Support can be tailored to your pulling pattern.
You and your clinician can discuss what fits your needs, preferences and health.
Based on NHS · International OCD Foundation
Hair health and behavioral support can be considered together.
A clinician can assess hair loss and other possible causes, and discuss psychological approaches such as habit reversal within appropriate care. Ask how treatment will be adapted to the situations that matter to you. This page does not give a self-directed training protocol.
Tell a clinician if hair has been swallowed; this can cause serious physical problems. You do not need to handle a physical-health concern through a questionnaire.
Context
When do you notice it, if you know?
Impact
What is becoming difficult or distressing?
Health
What needs medical attention alongside psychological care?
Based on NHS · International OCD Foundation
A little clarity. A place to start.
Explore a tool, prepare a conversation or find someone to talk to. Choose what feels useful to you.
Prepare for a conversation
A few prompts to help you explain what you have noticed and what you would like help with.
- A simple notes builder
- Copy your notes to keep
- No account needed
You decide how much to write and share.
Find your wordsFind your next kind of support
Explore where to begin with everyday support, professional help or an urgent conversation.
- Ways to ask for help
- Country-specific crisis contacts
- Support at your own pace
If you need urgent help, go straight to support.
Find supportYour first sentence does not need to be perfect.
Try describing the pulling and one effect on your day. If you want someone close to you involved, explain what support you would find welcome. You can ask for privacy when discussing details.
Based on NHS · International OCD Foundation
“I've been pulling my hair and finding it hard to stop. It is affecting me, and I would like help understanding the pattern and the support available.”Make it sound like you
Your questions, with room for nuance.
You can read just the answer you need.
Do I have to know why I pull before getting help?
No. You can describe what you have noticed and what you want help with. Assessment and treatment can explore relevant situations without treating the behavior as a failure of willpower.
Based on NHS · International OCD Foundation
Where this information comes from.
Use this hub to learn and prepare questions. It does not diagnose you or recommend a personal treatment plan. By Selfmora editorial; sources checked . Updated .
Additional explanations and examples: sources consulted . Examples illustrate ideas; they do not assess your personal health. Your questions
- Trichotillomania (hair pulling disorder)
- Body-Focused Repetitive Behaviors
- Comprehensive Behavioral Treatment for Skin Picking and Hair Pulling Disorders
- The Massachusetts General Hospital Hairpulling Scale: development and factor analyses