Debunking Myths: Understanding Trichotillomania

By Dorin Azérad, Stylist, Élan Hair Studio, Houston, TX

Trichotillomania, often misunderstood, is a complex mental health condition characterized by the compulsive urge to pull out one’s hair. Despite its growing recognition, many myths surround this disorder, perpetuating stigma and misinformation. These misconceptions can hinder understanding and support for those affected. In this article, we’ll explore five prevalent myths about trichotillomania, debunking each one to provide a clearer picture of the condition. By shedding light on the realities of trichotillomania, we, as hair loss practitioners, can foster greater empathy and awareness, ultimately encouraging better support for individuals navigating trichotillomania

Myth: People who pull out their hair can "just stop."

One of the most prevalent myths about trichotillomania is the belief that individuals can simply "stop" pulling out their hair if they want to. This misconception undermines the complexity of the disorder. Trichotillomania is classified as a mental health disorder, and the urge to pull hair can at times be a coping mechanism for stress, anxiety, or boredom. For many, this behavior is not a matter of willpower but an impulsive action that feels almost uncontrollable; imagine being told to not scratch when you have an itch.

Understanding that trichotillomania is not just a “bad habit” but a serious condition is crucial for hair loss practitioners and stylists. Labeling trichotillomania as a bad habit can perpetuate shame and isolation, as it overlooks underlying psychological complexities and discourages individuals from seeking the support they need.

Myth: Hair pulling is a type of self-harm.

Trichotillomania and self-harm are classified as distinct from one another in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). While both behaviors involve physical alterations to the body, trichotillomania is primarily a compulsive disorder rather than an act of self-harm intended to inflict pain or punishment. Although trichotillomania results in hair loss, that is an unintended result of the behavior. On the other hand, self-harm has an intentionality attached to it.

In fact, for many with trichotillomania, the act of pulling out one’s hair is considered to be self-soothing. Understanding this distinction is crucial for fostering empathy and providing appropriate support to clients with trichotillomania.

Myth: Hair regrowth is guaranteed.

A common myth surrounding trichotillomania is the belief that hair will always grow back, regardless of the extent of pulling. While it's true that many individuals experience regrowth after episodes of hair loss, repeated and severe pulling can lead to permanent damage to hair follicles, resulting in lasting bald patches or thinning.

Even when hair does regrow after episodes of pulling, it may emerge with a different texture, curl pattern, or even gray, reflecting changes in the hair follicles and overall health. A scalp analysis can reveal the health of hair follicles by determining whether they are active or dormant, providing insights into potential regrowth and treatment options.

Myth: Only women have trichotillomania.

Trichotillomania can and does affect individuals of all genders. Research indicates that boys and girls experience trichotillomania equally in childhood. However, by adulthood, 80-90% of reported cases are women. There are some questions as to whether the adulthood statistics are as skewed as represented. Some research has shown that more adult men have trichotillomania than may be reported. Those men affected by trichotillomania might choose to conceal their disorder by shaving their problem areas (ex. beard or head).

Myth: Trichotillomania is rare.

Research suggests that trichotillomania affects approximately 1-2% of the population, making it more common than many people realize. By recognizing that trichotillomania is not uncommon, professionals can create a more informed and compassionate environment, encouraging open conversations and providing better resources for clients who may feel isolated in their experiences.

Ultimately, a greater awareness of trichotillomania will enable our community to offer better care and create a supportive community for those navigating life with trichotillomania.