Trichotillomania and Eating Disorders

What is Trichotillomania?

Characterized as an impulse control disorder, Trichotillomania is a compulsive urge to pull out one’s own hair, commonly from the scalp, arms, and pubic areas. It can be known more informally as hair-pulling disorder. Trichotillomania is defined as a self-induced and continuing loss of hair and may be utilized to release tension or generate gratification or a sense of relief.  The peek onset of trichotillomania has been observed to be between 9 to 13 years of age.  This disorder is classified as a co-occurring disorder, which means that it typically develops with another illness, such as an eating disorder like anorexia, bulimia, or binge eating.

Trichotillomania Signs and Symptoms

If you or a loved one is struggling with trichotillomania, it is likely that the following will be experienced.

Signs and symptoms of trichotillomania include:

  • Patchy or bald regions on the scalp or other areas of the body
  • Spare or missing eyebrows or eyelashes
  • Repetitively pulling hair out, usually from scalp, or other regions of the body
  • Experience of strong urges to pull hair out, followed by feelings of release after hair is pulled
  • Playing with pulled-out hair
  • Chewing or consuming hair that has been pulled-out

What Causes Trichotillomania

The cause of trichotillomania is uncertain, but it is hypothesized that trichotillomania is likely the result of a combination of factors, including genetic, biological, and environmental factors.  Because of the physical effects resulting from this disorder, the sufferer can develop decreased self-esteem and become socially isolated.  Medical complications can also result from trichotillomania and include infection, permanent hair loss, or gastrointestinal obstruction if hair is ingested.  Individuals suffering from trichotillomania may also have other disorders, such as depression, anxiety, or eating disorders.

Connection & Relationship between Trichotillomania and Eating Disorders

Trichotillomania shares many clinical features and and overlaps with eating disorder treatment options.  Both disorders may evolve as a method of inadvertently dealing with an internal conflict or underlying issue.  Additionally, both illnesses encompass some degree of obsessive-compulsiveness.  Men or women who are struggling with an eating disorder may feel corresponding urges or compulsions to pull out their hair or only feel momentary relief from tension when hair is pulled.

Treatment for Eating Disorders and Trichotillomania

Because of the similarities of these two disorders, it is imperative that the co-occurring conditions be treated simultaneously.  Treatment options for treating both of these conditions include psychosocial methods, such as the use of cognitive-behavioral methods, as well as the utilization of medications.  Ideally, all implemented strategies for addressing these issues should be under the guidance of a comprehensive treatment team of eating disorder specialists.  These strategies and treatment options are highly effective in resolving underlying issues, thus promoting healing from both disorders.

Last Reviewed By: Jacquelyn Ekern, MS, LPC on April 25, 2012

Page last updated: June 12, 2012
Published on, Help for Eating Disorders