What causes trichotillomania?

Posted on Mon, 10 Aug 2015 in Skin Hair and Nails
Question: Any doctor specialize in trichotillomania? I have had it since i was 9, im 22 now and looking for help, real help, real information
Answered by Dr. Suresh Heijebu 3 minutes later
The condition you are seeking help is an impulsive control disorder where you have compulsive urge to pull hair. Kindly visit a psychiatrist for help. You will improve with psychotherapy and minimal drugs.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Suresh Heijebu 19 hours later
I have tried my doctor and hes tried numerous different medications but all 7 have made it worse. I feel hopeless
Answered by Dr. Suresh Heijebu 50 minutes later
Brief Answer:
Behavioural therapy is the cornerstone in the management.

Detailed Answer:
Hi Mam,

I understand your concern.

Currently available evidence suggests that the first line of treatment for trichotillomania is behavioral treatment and intervention.

No medication has been approved for the treatment of trichotillomania. Drug therapy has largely been disappointing.

A psychiatrist should be consulted ONLY when a serious psychiatric disorder is suspected.

Consultations with other specialists
eg, a Psychologist or a Developmental-behavioral pediatrics specialist,
should be obtained as indicated.

In current practice, behavioral treatment seems to be the most powerful treatment, even for patients older than age 16 years.

I suggest you the following behavioural strategies.I hope they can help you.

1.Habit reversal -
Increasing awareness of the habit;learning a competing response to practice when you feel the urge to engage in the habit, practicing stress and anxiety reduction procedures on a daily basis; and support and encouragement from parents.

2.Self-monitoring -
This involves systematically observing and discriminating when the behavior occurs, recording the responses, and evaluating one’s own behavior.

3.Competing reaction training -
This is a component of habit reversal that is occasionally used alone; you should be taught a socially appropriate alternative behavior or response and encouraged to practice it on a daily basis when they feel the urge to engage in the habit, in situations where the habit historically occurs or for 1 minute after the occurrence of the habit.

4.Relaxation training -
This involves to identify own bodily sensations associated with tension and then employ procedures designed to induce relaxation; typically, it is individualized and may include such procedures as deep-breathing strategies and systematic muscle tensing and relaxation.

5.Psychotherapy -
This process involves direct communication (mainly talking) between you and therapist , one of its most popular forms is cognitive-behavioral therapy (CBT).

6.Hypnosis -
This is a process of controlling physiologic responses by focusing attention on specific mental images for therapeutic purposes, typically to gain more control over behavior, emotions, or physical well-being; in a hypnotized state, the subject is more open than usual to suggestions (provided by the hypnotist) for subsequent changes in behavior.

I also request you to provide your residential area,city and country for identifying any therapists who can deal with Trichotillomania and Impulse control disorders.

Post your further queries if any.
Thank you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Suresh Heijebu

General & Family Physician

Practicing since :2010

Answered : 3656 Questions


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