TRICHOTILLOMANIA

Trichotillomania is one of the Obsessive Compulsive Disorders (OCDs). It is also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. It describes an impulsive disorder of the mind where individuals cannot prevent the urge to pull out their hair from various body parts like eyebrows or eyelashes, scalp, beard, or mustaches. 

PSYCHOPATHOLOGY

1) Trichotillomania is one of the types of traumatic alopecia and is defined as the irresistible urge to pull out the hair, accompanied by a sense of relief after the hair has been plucked

2) In trichotillomania alopecia results from deliberate efforts of the patients who is under tension or is psychologically disturbed

3) The condition maybe episodic and the chronic type is difficult to treat. The prevalence of the condition appears to be more common than previously believed

4) The purpose of this article is to discuss the various aspects of the condition including the available treatments

5) It is noted predominantly in girls and women and occurs more commonly in children than in adults. It occurs more than twice as frequently in females as in males

6) The preponderance may be due in part to women′s greater willingness to seek medical care; men may hide their hair pulling better by masking if as male pattern baldness and shaving their mustaches and beards

7) Affected children may be seven times more than adults. The age of onset is usually between 5 and 12 years with equal sex distribution or early childhood to adolescence

8) When it occurs later in life, during adulthood or in older patients, it is associated with psychopathology and with c poorer prognosis

CLINICAL FEATURES

1) Scalp is involved in majority of cases Eyebrows, eyelashes, facial hairs, pubic, axillary, chest, abdominal or extremity hairs are involved in some.

2) The hair pulling develops gradually and unconsciously but is not usually denied by the patient in the younger age group

3) In more severe form, the patient usually consistently denies plucking his or her hair. Most frequently hair is plucked from one front-parietal region, which is on the side of manual dominance

4) The temporal and occipital regions are usually spared. Typically the hairs are short, irregular, broken at various distance and distorted

5) On scalp an ill-defined patch develops in majority, but the full scalp may be involved in some. The clinical presentation of the lesion is characteristic

6) The linear or circular patches with irregular borders containing hairs of the varying length, the shortest being those most frequently plucked, result due to plucking of hairs either in a wavelike fashion across the scalp or centrifugally from a single point

7) Less severely affected patients may have only small areas of baldness or imperceptible thinning over the entire head

CAUSES

I. Genes: People who do hair pulling may have genes that make it more likely.

II. Hormones: Puberty hormones and stress hormones may prompt hair pulling to start in those who have the genes for it.

III. Habit learning: Many people with trichotillomania feel an itch, tingling, or an urge to do it. When they pull hair, they get a brief sense of relief. To the brain, this relief is a reward. The brain releases reward hormones, such as dopamine. This links hair pulling with the reward. It causes a hair-pulling habit to form.

PSYCHOTHERAPY: It is one of the effective treatments for mental disorders. Psychotherapy for Trichotillomania may incorporate psychological treatment, which endeavors to recognize and adjust the thoughts and feelings that lead to specific practices, for example, hair pulling. Common treatments for people with Trichotillomania incorporate reversing the daily habits, emotional supports, and controlling the impulse to pull out hair.

1) Contending response training: The individual works on replacing the hair pulling habit with an alternate habit. This training is useful for children and teens.

2) Inspiration and consistency training: The individual participates in exercises and practices that help them to remember the significance of staying with the treatment. This may incorporate accepting praise from family members for progress made during treatment.

3) Relaxation training: The individual practices unwinding strategies, for example, reflection and profound relaxation. These methods of training help them to ease their pressure and stress and ultimately reduce the hair pulling.

4) Generalization training: The individual practices their new abilities in various circumstances to get programmed in their daily routine.

5) Family therapy: Family therapy is especially valuable when a kid or youngster has a significant issue that is influencing the other family members, as may be the case with Trichotillomania. Your family can assist you in addressing the issue that is making you pull your hair. In this treatment, a counsellor will meet the entire family and study their perspectives and connections to comprehend the issues the family is having. It encourages relatives to discuss the issues better with one another.

6) Hypnosis: is also a proven treatment method which can be utilized to adjust your condition of consciousness. The hypnotist would then be able to recommend a solution like changing your conduct. While you are in this modified state, you might be bound to acknowledge the recommended changes and quit the habit of pulling your hair.