What causes hair pulling leading to hair loss and how can it be treated?

Symptom Database

Have you ever found yourself mindlessly pulling at your hair, only to realize later that you have caused noticeable hair loss? If so, you may be experiencing a condition known as trichotillomania. This hair pulling disorder can be distressing and can lead to significant hair loss. In this article, we will explore the causes of hair pulling leading to hair loss and discuss various treatment options for managing and overcoming trichotillomania.

Understanding Trichotillomania

Trichotillomania is a psychological disorder characterized by the irresistible urge to pull out one’s hair. This can include hair from the scalp, eyebrows, eyelashes, or any other body hair. The act of hair pulling provides a sense of relief or gratification for individuals with this disorder, but it often leads to noticeable hair loss and can cause significant distress.

The Causes of Hair Pulling

The exact cause of trichotillomania is not fully understood, but it is believed to be a combination of genetic, environmental, and psychological factors. Some potential causes and triggers of hair pulling leading to hair loss include:

  • Stress and anxiety: Hair pulling can be a coping mechanism for individuals experiencing high levels of stress or anxiety.
  • Boredom or inactivity: People may engage in hair pulling as a way to occupy their hands when they are bored or have nothing else to do.
  • Perfectionism: Some individuals with trichotillomania have a strong desire for symmetry or perfection, leading them to pull out hairs that they perceive as imperfect.
  • Emotional regulation: Hair pulling can serve as a way to regulate emotions, providing a temporary sense of control or relief.
  • Genetic predisposition: There may be a genetic component to trichotillomania, as it often runs in families.

Treating Hair Pulling and Hair Loss

While there is no known cure for trichotillomania, there are various treatment options available to help individuals manage and overcome their hair pulling habits. It is important to seek professional help from a mental health professional experienced in treating trichotillomania to develop an individualized treatment plan. Some common treatment approaches include:

Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy is a widely used and effective treatment for trichotillomania. This therapy focuses on identifying and changing the thoughts and behaviors associated with hair pulling. Through CBT, individuals learn alternative coping strategies and develop healthier habits to replace hair pulling.

Habit Reversal Training (HRT)

Habit reversal training is a specific type of therapy that aims to increase awareness of hair pulling behaviors and teach individuals how to interrupt and replace those behaviors with more constructive actions. This technique often involves keeping a hair pulling diary and implementing specific strategies to prevent hair pulling.


In some cases, medication may be prescribed to help manage the symptoms of trichotillomania. Selective serotonin reuptake inhibitors (SSRIs) and other psychiatric medications can be used to reduce the urges and anxiety associated with hair pulling. However, medication should always be used in conjunction with therapy for the best results.

Promoting Hair Regrowth

Once hair pulling has caused noticeable hair loss, promoting hair regrowth becomes a priority for many individuals. While regrowth may take time, there are several strategies that can help stimulate hair growth:

Healthy Diet and Nutritional Supplements

A balanced diet rich in vitamins and minerals is essential for healthy hair growth. Nutritional supplements, such as biotin and iron, can also support hair regrowth. Consult with a healthcare professional to determine the best supplements for your specific needs.

Scalp Massage and Stimulation

Gently massaging the scalp can increase blood flow to the hair follicles, promoting hair growth. Using essential oils, such as lavender or rosemary, during the massage can further enhance the regrowth process.

Avoiding Further Damage

It is crucial to avoid further damage to the hair and scalp to allow for regrowth. This includes refraining from hair pulling, using gentle hair care products, and avoiding excessive heat styling or chemical treatments.

Coping with Hair Pulling and Overcoming Trichotillomania

Managing trichotillomania and coping with hair pulling can be challenging, but with the right strategies and support, it is possible to overcome this disorder. Here are some tips to help you on your journey:

Build a Support System

Reach out to friends, family, or support groups who can provide understanding and encouragement. Sharing your experiences with others who have gone through similar struggles can be incredibly helpful.

Identify Triggers

Pay attention to the situations, emotions, or thoughts that trigger your hair pulling. By identifying these triggers, you can develop strategies to avoid or manage them effectively.

Practice Stress Management Techniques

Engage in activities that help reduce stress and promote relaxation, such as exercise, meditation, deep breathing, or journaling. Finding healthy outlets for stress can reduce the urge to engage in hair pulling.

Replace Hair Pulling with Alternative Behaviors

Find alternative activities to occupy your hands and redirect the urge to pull hair. This could include squeezing a stress ball, playing with fidget toys, or engaging in a hobby that keeps your hands busy.

Be Patient and Kind to Yourself

Overcoming trichotillomania takes time and effort. Remember to be patient with yourself and celebrate small victories along the way. Treat yourself with kindness and compassion throughout the healing process.

In conclusion, hair pulling leading to noticeable hair loss is a common symptom of trichotillomania. Understanding the causes of hair pulling and seeking appropriate treatment is essential for managing and overcoming this disorder. With the right strategies, support, and patience, it is possible to regain control over hair pulling habits and promote hair regrowth.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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