Trichotillomania (TTM) By: Roxanna Ramirez Roxanna Ramirez

Introduction Trichotillomania (TTM) is characterized by patchy alopecia of hair bearing areas. This is because of compulsive urge to pull the hair. Scalp is the most common site for pulling hair. Usually, patients may have only small areas of baldness and in severe forms. Diagnosis is by history and clinical examination. However, it is difficult to distinguish from other causes TTM. Roxanna Ramirez

Trichotillomania Also known as compulsive hair pulling. A person can be diagnosed with trichotillomania if: What is Trichotillomania? Also known as compulsive hair pulling. Repeating pulling out of one’s hair. Result in noticeable hair loss. Sense of tension when pulling out the hair. Pleasure, satisfaction, or relief when pulling out the hair. Not caused by another mental or medical condition. Causes significant distress or interference in one’s life The repeated pulling out of one’s hair results in noticeable hair loss, and There is an increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior, and There is pleasure, satisfaction, or relief when pulling out the hair, and The condition is not caused by another mental or medical condition, and The condition causes significant distress or interference in one’s life. Roxanna Ramirez

Common habits include A need to extract an intact hair bulb. A need to bite or mince the hair or hair bulb. Tactile stimulation of lips or face with the hair shaft. A need to pull the hair in a particular manner. Placing, saving, or discarding hairs in a ritualistic way. Twirling, rolling, or examination of the hair. Searching for hairs that don’t feel right (i.e. coarse). Searching for hairs that don’t look right (i.e. color). Feel compelled to make their hairline absolutely even. Swallowing their hair. Roxanna Ramirez

Why? What would cause a person to pull out their hair? Doctors don’t know much about the disorder Believe that it can be inherited through genes. Doctors believe that it is a chemical imbalance in the brain. Psychiatrists believe that trichotillomania is related to OCD since both are anxiety disorders Roxanna Ramirez

Are there certain ages that this condition tends to begin? Occurs about equally for each gender in young children Commonly associated with young children. Between 2-13 years of age Including as an infant or in pre-school. Children are most likely to pull hair from another person, pet, or dolls Most individuals tend to start pulling their hair during childhood or adolescence, but it can start at any age including as an infant or in pre-school. Roxanna Ramirez

Medical Complications Trichophagy. (ingesting hair) Ingesting hair can result hairballs. Which can cause intestinal obstruction or perforation. They often necessitate surgical removal. Teeth can become grooved due to the repeated sliding of hair shafts between them. Trichophagy (ingesting hair) can cause serious medical complications. Roxanna Ramirez

Common parts of the body that people pull and percentages. Roxanna Ramirez

Trichotillomania can cause… Pulling of hair does not cause pain. Higher pain threshold. The experience of pain may act as an anxiety or tension reducer. Causes clinically significant distress Socially disconnected Problems in getting a job Or other important areas of performance. Most report that pulling of hair does not cause pain. Those who pull their hair may have a higher pain threshold. The experience of pain may act as an anxiety or tension reducer. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Roxanna Ramirez

They would… Hide the evidence of their condition. Wigs, elaborate hairstyles, creative cosmetics, hats, avoidance of water and wind, etc. Avoidance behaviors can take the form of not participating in common social situations such as dating, for fear of being “found out”. Many individuals with Trichotillomania will go to great lengths to hide the evidence of their condition. Wigs, elaborate hairstyles, creative cosmetics, hats, avoidance of water and wind, etc. Avoidance behaviors can take the form of not participating in common social situations such as dating, for fear of being “found out”. Roxanna Ramirez

Treatments Cognitive-Behavioral Therapy Medications Alternative Therapies Support Groups An important barrier to treatment is that those who pull their hair often experience extreme embarrassment and consequently do not seek treatment. Most often they neither realize that effective treatments exist, nor do they realize that this condition is not uncommon. Roxanna Ramirez

Conclusion Trichotillomania (TTM) is often chronic and difficult to treat. Hence, early diagnosis and treatment is necessary. It is believed that the trichoscopy plays a vital role in the diagnosis of this condition by demonstrating specific trichoscopic patterns. Roxanna Ramirez