Friday, July 24, 2009

Sue Scheff: Trichotillomania or Hair Pulling Disorder

Trichotillomania, or “hair pulling” is an impulse-control self injury disorder which affects approximately 10% of the population, occurring twice as often in females than in males. While hair pulling most commonly begins during adolescence, it has been found to occur in children as young as one year old!

People with hair pulling disorder pull out hair (root and all) from one or any number of areas all over their body. Some patients will pull out patches of hair at a time, while others pull hair out a strand at a time. Patients then may play with the freshly pulled hairs, and roughly half of all pullers put the freshly pulled hairs in their mouths. Hair pullers may also be nail biters or exhibit some other form of compulsive disorder. They may also suffer from depression, anxiety or obsessive-compulsive disorder (OCD).

Doctors still do not understand much about hair pulling, but hypothesize that it may be directly related to OCD, and may be caused by an imbalance of neurotransmitters in the brain. Like other forms of self abuse, the pain caused by pulling the hair out of the body can also create a feeling of relief in the puller, though that relief is short-lived, which is why pullers continue to pull.

While trichotillomania is less “dangerous” than other self injury behaviors (such as cutting) it can still be quite damaging to teens that have the disorder. Often teens with hair pulling disorder will have very thin hair or large obvious bald spots on their heads, which can cause negative comments and taunts from peers. As a result teens may have a harder time dealing with feelings of depression and these feelings can increase. Teens may as a result become more withdrawn from daily life and activities, and be more likely to hide or skip school or social activities.

Recently scientists have uncovered a set of two genetic mutations that may be responsible for causing trichotillomania. These mutations are known as SLITKR1 mutations, and are present in a small percentage of trichotillomania patients. These mutations may eventually lead to better ways to treat patients with trichotillomania, but for now are still being studied. For more immediate treatment of hair pulling, treatments like therapy and prescription anti-depressants like Zoloft and Paxil seem to be very affective at helping hair pullers with their impulse control problems.