Pulling Your Hair Out – Trichotillomania – Causes, Treatment

Have you ever been so frustrated that you felt like “pulling out your hair”?

What is Hair Pulling Disorder

Hair pulling is the imagined act of gripping and removing a person’s hair to the point where some or all of their hair is pulled out, either at, near hair roots (called “yanking”) or more at the scalp (called “pulling”).

People that want to pull their hair may not have any problem with it because they may sometimes reason that it releases uncomfortable emotions.

They believe that pulling hairs is an effective coping mechanism to reduce pain. However this notion is entirely false, instead they are likely hurting themselves physically and psychologically which results in anxiety of being judged, punished by society or experiencing social anxiety disorder.

Chances are you threw your hands up in a gesture of frustration but made no attempt to harm your hair.

But people with a disorder called trichotillomania compulsively pull out their hair – sometimes to the point of balding their scalp and destroying most of their eyelashes. And this isn’t a rare condition either. Estimates are that up to 3% of people have a hair pulling addiction.

What Causes Hair Pulling Disorder – Trichotillomania?

According to researchers at Duke University, compulsive hair pulling may be in the genes. Specifically, they found that a gene called SLITRK1 is involved in trichotillomania and other disorders where a person has a problem controlling their impulses.

When this gene is mutated, it causes abnormal communication between nerve cells, which can trigger the urge to tug at one’s hair.

Not everyone who has trichotillomania has this gene mutation, so environment probably plays a role too. In fact, other emotional problems like anxiety and depression are more common in people who compulsively pull on their hair – and hair pulling may be used as a way to relieve stress.

Most hair pullers describe a sense of relief after tearing out a handful of hair. Some people who have a hair pulling addiction aren’t even aware they’re pulling out hair and may not remember doing it.

Can Hair Pulling Disorder Be Treated?

Trichotillomania is an impulse control disorder mainly due to genetics, but it usually starts in a person’s teenage years. It might be caused by being adopted, in which case genetic predisposition can have something to do with it. Anyway, one of the underlying reasons for this grooming disorder involve sensory input as a way of changing moods and emotions.

Trichotillomania cannot be cured but symptoms can be reduced through therapy such as cognitive behavioral therapy (CBT). Up to 17% of adults with this condition are mentally ill.

Yet, the condition may still go untreated all because public opinion around mental health has shifted and doctors are afraid they will be blamed for doing nothing beyond prescribing medications that offer little relief or acceptably and generously prescribe medications that are not best suited to patients with mild conditions like trichotillomania.

Traditionally, doctors have been used behavioral therapy and medications such as anti-depressants to treat trichotillomania with varying degrees of success. Recently attention has turned to a new treatment – an antioxidant called n-acetylcysteine, or NAC.

How Long Does It Take For Nac To Work

In a study published in the Psychopharmacologi Institute, 56% of people with trichotillomania showed improvement on NAC (n-acetylcysteine) after only 9 weeks. This was a small study involving only 50 people, but it was randomized and double-blinded, which adds legitimacy to the results.

N-acetylcysteine (NAC) works by altering levels of an amino acid in the brain called glutamate, which plays a role in impulsive behaviors.

 Even better, n-acetylcysteine is available at most health food stores and is safe when taken in reasonable doses. 

Because it’s an antioxidant, n-acetylcysteine may have other benefits as well. Some small studies show it slows down aging in mice and reduces fatigue in athletes.

Pharmacologic Treatment of Hair-Pulling and Skin-Picking Disorders

Trichotillomania and Hair Pulling Addiction: The Bottom Line?

Compulsive hair pulling is a surprisingly common disorder that can cause considerable frustration and loss of self-esteem for the unlucky person who has it. Fortunately, a natural antioxidant called NAC could help to treat chronic hair pullers – before they end up bald.


ABC News. “Compulsive Hair Puller? Not Your Fault”

Trichotillomania Learning Center. “N-acetylcysteine for Trichotillomania, Skin Picking, and Nail Biting”

Archives of General Psychiatry. July 2009.