Hair Loss Caused by Trichotillomania
Hair loss can be triggered by various reasons; some of them can be avoided in order to stop further development. Since women tend to experiment with hair styles, it can lead to hair damage and luckily, the condition can be reversed if follicles are not damaged by simple change of hair style. Another cause of hair loss is called trichotillomania , which is hair pulling disorder, requiring counseling and therapy.
It is a condition caused by the child pulling, plucking, twisting, or rubbing his or her hair, which results in hair loss in patches and it’s characterized by broken hairs of varying length. Even though the consequence is hair loss and patients come for help to dermatology office, they in fact need to treat the cause, which is rooted in the psyche. It is one of several that have psychosocial aspects that must be addressed for full disease resolution. They usually pull the hair of the scalp, but may involve other areas.
This kind of behavior that can lead to disorder can begin at different age, with one third of children that have it before the age of 10. In the case that it affects teenagers, there are greater chances to be associated with depression, anxiety, obsessive-compulsive disorder, eating disorders and substance abuse.
There are automatic and focused subtypes of trichotillomania. The first one is more frequent and is characterized as hair pulling while engaging in other activities, making them unaware of it. On the other hand, the focused type involves setting aside time and attention specifically for hair pulling, reliving tension after pulling. The condition includes recurrent pulling out of one's hair resulting in noticeable hair loss, an increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior, pleasure, gratification, or relief when pulling out the hair, the disturbance is not better accounted for by another mental disorder and is not due to a general medical condition, the disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Children with trichotillomania feel calm because of the tactile stimulation via the fingertips. There have been reports of pulling the hair of siblings, pets, dolls, and stuffed animals. The trigger can be family psychosocial stressor like separation from a familiar object like moving to a new house, or person due to a divorce for example, birth of a younger sibling, recent illness/hospitalization, school, and sexual abuse. One part of these patients engages in trichophagia, which is a medical term for eating hair. On physical examination, clues for diagnosing trichotillomania include hairs of varying lengths, broken short hairs, vellus or indeterminate hairs, and empty follicular orifices.
Trichotillomania treatment is not simple, because it has some similarities with obsessive-compulsive disorder, so anti-depressants are most commonly used. Habit reversal therapy is a type of cognitive behavior therapy that has proven effective in the treatment of trichotillomania. This therapy involves teaching patients about their disorder and providing relaxation techniques and specific muscle-tensing activities. In theory, the habit of muscle tensing replaces the habit of hair pulling.