Hair Pulling Disorder- It is not bad to pull hair out of extreme happiness and anger or pulling hair by grandchildren, there is a comfort. But it is certainly not good to pluck hair, consciously or sub-consciously, one by one making a large portion of the head empty. ‘Trichotillomania’ is a mental disease and the patients of this disease pull and pluck their hair.

1. HAIR PULLING DISORDER
OR TRICHOTILLOMANIA
en.monerkhabor.com
Author: Professor Dr. Shalahuddin Qusar
Biplob
(Professor and Chairman- Psychiatric Sex
Clinic, Dept. of Psychiatry, Bangabandhu
Sheikh Mujib Medical University- BSMMU,
Dhaka, Bangladesh and Former Mental
Skills Consultant, Bangladesh Cricket
Board)

2. Hair Pulling Disorder- It is not bad to pull hair out of extreme happiness and
anger or pulling hair by grandchildren, there is a comfort. But it is certainly not
good to pluck hair, consciously or sub-consciously, one by one making a large
portion of the head empty. ‘Trichotillomania’ is a mental disease and the
patients of this disease pull and pluck their hair.

3. TRICHOTILLOMANIA
• Trichotillomania (TTM), also known as hair pulling disorder, is a mental
disorder characterized by a long-term urge that results in the pulling out of
one’s hair. This occurs to such a degree that hair loss can be seen. This is a
mental disorder where the patient or the affected person pulls his hair
down. The patient makes it a habit and always does it. Therefore, he
becomes bald gradually.
• At first, it does not seem to be a problem. But the person becomes
addicted to this habit eventually. At one stage he cannot restrain himself
from doing it. He feels distressed if he abstains. He feels a little relief after
pulling his hair for a short period of time but afterward, it becomes the
reason for his discomfort. At present, this disease is considered a part
of obsessive-compulsive disorder.
• Many people say that the person suffering from this hair pulling disorder

4. WHEN AND WHOM?
• Both men and women can be affected by this disease. However, it affects
women relatively more than men. The most common age of onset of
trichotillomania is between ages 11 to 13. In some cases, it may onset before
(2-6 years) but most of them become well soon.
• The incidence of this disease is seen in different people of the same family.
So there is a hereditary link. It happens also because of the problems in
neurotransmitters, serotonin, and dopamine. Cats, dogs or horses have
similar problems.

5. WHAT IS HALLUCINATION?(CONT…)
• In many cases, we see at the beginning of the disease or after a few days of
treatment, some patients, especially who are intelligent, understand the
matter that the experience that they are having is not real. And then it
becomes painful for him. Many people cry a lot and they cry and do not
want to listen to those sounds that they hear. Some people even hit their
head to the wall too. These experiences are illusory and not a miracle at all
rather a grotesque feeling related to a disease.

6. PLACES
The scalp is the most common pulling site, followed by the eyebrows,
eyelashes, face, arms, and legs.
Scalp 75%, eyelashes 53%, eyebrows 42%, pubic hair 17%, beard 10%,
mustache 7%, arm 10%, leg 7%, chest hair 3%, bally 2%. This is the closest
figures.

7. SOCIAL DISCOMFORT
Patients may be ashamed or actively attempt to disguise their symptoms.
This can make diagnosis difficult as symptoms are not always immediately
obvious, or have been deliberately hidden to avoid disclosure. This ‘hair
pulling disorder’ disease brings social discomfort and embarrassment.
Patients always try to hide their symptoms from the society. Sometimes other
mental problems can be associated with this disease too.

8. SPECIAL GROUP
There is a special group who eat their hair after pulling. And it is extremely
horrible. It can obstruct the intestine in the stomach. The inner tubes of the
stomach can be stopped. Many have the habit of biting after pulling hair. It is
really harmful for the tooth.

9. TREATMENT: PSYCHO-EDUCATION
The biggest obstacle for treatment is the patient himself. The patient hides his
problems. Since he can do all the work normally without any obstacle, this
matter becomes the cause of extreme discomfort. Many even do not
consider it as a disease. So he, the patient, and his family have to accept this
‘hair pulling disorder’ as a disease first.

10. MEDICATION AND
PSYCHOTHERAPY
The treatment of this ‘hair pulling disorder’ disorder is a lot like the treatment
of OCD; Serotonin Reuptake Inhibitor and Cognitive Behavioral Therapy.
Habit Reversal Therapy is also beneficial for the treatment of this disease.

11. CAUTION
Many people think that this is a skin disease. Many people also visit a
dermatologist. Keep in mind that pulling own hair and hair fall are not the
same. As a result, it gets late to start the treatment.

12. VISIT:
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