Trichotillomania is the compulsive pulling of one's hair. It affects women more commonly. It is frequently connected with depressive and obsessive-compulsive disorders (1).
This condition presents as irregular single patches of hair loss, with hair present in the patches of varying lengths and some strands twisted. Usually a history of playing or twirling of the hair is obtained. Patches are seen most frequently on the scalp but can also involve the eyelashes, eyebrows, pubic hair, body hair, and facial hair (2).
The mean age of onset is around 12-13 years. Hair pulling in early childhood (<5 years of age) is considered to be self limiting and usually disappears without intervention (2).
Extreme forms may indicate and underlying psychiatric disease.
According to the 'Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)' the diagnostic criteria of tricotillomania are:
Patients may present with additional "nervous habits" such as - nail biting, knuckle cracking, touching or playing with pulled hair, and hair eating (trichophagia which can lead to intestinal obstruction) (2).
Medical complications of tricotillomania include:
Last reviewed 01/2020