Trichotillomania

Prevalence 

Approximately 1-3% of the population lives with TTM. Based on the lower end estimate (i.e. 1%), 231,300 individuals in Australia currently have TTM. It usually begins during puberty, and lasts an average of 20 years, although earlier onset in infancy and childhood is possible. Women generally seem more affected than men and report more severe and distressing experiences.

People with TTM sometimes also report skin-picking or nail-biting behaviours and can have other mental health conditions, such as depression or anxiety.  

Possible causes

There are many factors which contribute to TTM. Genetics can play a part, with family members more likely to experience TTM or similar disorders, such as obsessive-compulsive disorder (OCD).

Psychological factors, such as thoughts, managing feelings and perceived control over behaviours, can also contribute to symptoms of the disorder. Avoidance of emotions, positive and negative, has recently been proposed as an important underlying issue.

Negative social responses to hair loss, as well as cultural expectations about beauty, can act as further influences.

Symptoms

Its main feature is the repeated pulling out of hair, regardless of multiple attempts to stop the behaviour. This causes distress and interferes with important areas of life, such as relationships, work and well-being. 

Treatment options

The most effective treatment for TTM is behaviorally-based psychological therapies, which typically up to 15 sessions spread over 10 weeks.

Types of therapy are habit reversal therapy (HRT), cognitive behavioural therapy (CBT), or acceptance and commitment therapy (ACT) with added behavioural components. In Australia, treatment providers and support groups can be found by contacting the Anxiety Recovery Centre Victoria (ARCVic).

There are also a number of online support groups.