What does Trichotillomania mean ?
Trichotillomania is a combination of the Greek words hair (trich), plucking (tillo) and sickly impulse (mania), and it is the person’s hair plucking repetitively and creating distinct balding areas. It was first used by dermatologist Hallopeau in 1889 to describe the hair-plucking behavior in a child. Although trichotillomania has been described for a long time, research on its etiology and treatment has been neglected for a long time, but research has increased relatively in recent years. Among the characteristic features of this disease; The behavior of the person plucking his own hair over and over again, resulting in noticeable hair loss, draws attention. Increasing tension before plucking and attempts to resist this behavior fail, and a feeling of pleasure, satisfaction or comfort while pulling hair is often accompanied.
It is assumed that trichotillomania is on the spectrum of obsessive-compulsive disorders (OCD), that it is a type of behavioral addiction, that it shows addictive behavior characteristics, and that some species-specific behaviors are evolutionarily equivalent in humans. Compulsive nature of hair plucking in trichotillomania, resistance to pulling urge, difficulty in controlling the impulse, presence of excessive, involuntary rituals, decrease in negative emotions such as tension, anxiety, distress in patients with pulling behavior, good response to drugs used in OCD treatment such as clomipramine and obsessive-compulsive in the family history of patients. It has been suggested that the disorder should be included in the OCD spectrum due to its high prevalence. Although most of the patients with trichotillomania are aware of the negative consequences, they continue to pull out hair. They also find it difficult to control plucking and exhibit the main characteristics of addictive behavior, such as feeling a strong desire for plucking and getting pleasure while doing so.
The etiology of trichotillomania is still unknown. Many etiological factors have been suggested as the cause. It has been suggested that the onset of hair plucking is related to life events such as parents’ divorce, moving from the area of residence, changing school, physical and psychological violence, trauma, loss, or perception of loss. In diseases with trichotillomania, mainly anxiety and depression, other mood and anxiety disorders and substance use disorders are common. Coexistence of axis I disorders has been reported between 64-78% in trichotillomania.