TTM is currently defined as an impulse control disorder, but the are still questions about how it should be classified.Pronounced trik-o-til-o-may-nee-ah," trichotillomania was named in 1989 by  french dermatologist, Francois Hallopeau, from the Greek words for "hair" {tricho} and "to pull" {tilo}. "Mania" is defined as "excessive and intense interest in or enthusiasm for something"

Trichotillomania {TTM or "tric"} is a disorder that causes people to pick skin or pull out hair from there scalp,eyelashes,eyebrows,or any other  parts of the body, resulting  in noticeable bald patches red bumps or skin erosion. Usually, but not always, the scalp and /or the face are the primary locations for hair pulling.

The defining characteristic of Trichotillomania is the recurrent, compulsive pulling out of one's own hair, often resulting in observable hair loss. Usually, but not always, the scalp and/or face are the primary locations for hair pulling. While the most common hair pulling sites are the scalp, eyebrows, and eyelashes, Trichotillomania may involve any part of the body with hair. Less common locations for hair pulling include the pubic area, perirectal region, arms, chest, and legs. An individual with Trichotillomania may use his or her fingernails, as well as tweezers, pins or other mechanical devices. In severe cases, Trichotillomania can result in permanent hair loss or skin damage.

Often, but not always, Trichotillomania episodes are preceded by a high level of tension and a strong "urge". Likewise, hair pulling is usually, but not always, followed by a sensation of relief or pleasure. Hair pulling is usually done alone, often while watching TV, reading, talking on the phone, driving or while grooming in the bathroom. A Trichotillomania episode may be triggered by a negative mood state or occur in response to stress, but may also occur while an individual is calm and relaxed. Sometimes hair pulling is done as a conscious behavior, but it is frequently done as an unconscious habit. Recent reports indicate that approximately 10% of those with Trichotillomania also eat their hair after they pull it (Trichophagia). This can result in hairballs called bezoars, which can lead to severe gastrointestinal blockage

As demonstrated above, Trichotillomania has obsessive-compulsive features that are quite similar to Obsessive-Compulsive Disorder (OCD), as well as Body Dysmorphic Disorder(BDD), and Dermatillomania, also known as Compulsive Skin Picking (CSP). In fact, it is not unusual for an individual with Trichotillomania to also have features of OCD, BDD, and/or CSP.

An individual with Trichotillomania may use his or her fingernails, as well as mechanical devices.In several cases, Trichotillomania can result in permanent hair loss or skin damage.Often, but not always.Trichotillomania episodes are preceded by a high level of tension and a strong "urge". Likewise, hair pulling is usually, but not always,followed by a sensation of relief or pleasure. Hair pulling is usually done alone, often while watching tv, reading, talking on the phone,driving,or while grooming in the bathroom.  A Trichotillomania episode may be triggered by a negative mood state or occur in response to stress, but may also occur while an individual is calm and relaxed,

Individuals with Trichotillomania often attempt to camouflage the hair loss that accompanies the disorder,Common camouflaging techniques include the use of hats, scarves,long sleeve shirts fake wigs. Some with Trichotillomania In extreme cases, individuals with Trichotillomania may even avoid social situations in effort to prevent others from seeing the hair loss that results from hair pulling/skin picking.

Symptoms

An individual with Trichotillomania may use his or her fingernails, as well as mechanical devices.In several cases, Trichotillomania can result in permanent hair loss or skin damage.Often, but not always.Trichotillomania episodes are preceded by a high level of tension and a strong "urge". Likewise, hair pulling is usually, but not always,followed by a sensation of relief or pleasure. Hair pulling is usually done alone, often while watching tv,reading,talking on the phone,driving,or while grooming in the bathroom. A Trichotillomania episode may be triggered by a negative mood state or occur in response to stress, but may also occur while an individual is calm and relaxed.

Individuals with Trichotillomania often attempt to camouflage the hair loss that accompanies the disorder,Common camouflaging techniques include the use of hats, scarves,long sleeve shirts fake wigs. Some with Trichotillomania In extreme cases, individuals with Trichotillomania may even avoid social situations in effort to prevent others from seeing the hair loss that results from hair pulling/skin picking.

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Warning Signs

People frequently pull while reading, writing, working on the computer, talking on the phone, watching TV, or falling asleep. Some people are conscious of what they are doing and others are not. Most people pull in private, but some will pull mindlessly in public while doing one of the above activities.

Hair Pulling: Causes

The cause of trichotillomania is not known. Research into the causes and treatments for TTM is still in the early stages. Preliminary evidence indicates TTM is a neuro-biological disorder and that genetics may play a role in its development. It is also possible that hair pulling may have several different causes, just as a cough can be caused by many different illnesses.

When and why do people pull?

While the underlying biology is not clearly understood at this time, we do know that people with trichotillomania generally have a neurologically based predisposition to pull their hair as a self-soothing mechanism. The pulling behavior serves as a coping mechanism for anxiety and other difficult emotions. It does not hurt and they are not trying to damage themselves. While the average age of onset is 11, trich can be found in children as young as one year old. Onset of trich can be triggered by simple sensory events, such as itchy eyelashes, or by stressful life events, and it can occur quite suddenly.

Hair Pulling: Impact & Effect

The Emotional and Social Impact of Trichotillomania

For some people, trichotillomania is a mild problem, merely a frustration. But recent research has shown that the overall impact of trichotillomania on its sufferers and their families tends to be more severe.

Feelings of shame about this behavior are exacerbated by how poorly trichotillomania is understood by both the general public and medical professionals. Trichotillomania often causes painful isolation. Shame leads many hair pullers to drastically curtail work, social and educational pursuits. Fear of exposure also leads many individuals to avoid vital medical care of all kinds, from gynecology to dentistry to dermatology. Hair pulling can lead to great tension and unhealthy dynamics within families. The time and expense spent covering up hair loss and seeking treatment are also significant.

Repetitive Motion Injuries

Hair pulling can lead to repetitive motion injuries, which do make it painful to move the arms or hands to pull hair. But often the pain cannot deter the urge to pull the hair.