• A repetitive hair-pulling disorder, often associated with skin-picking
  • Classified as an impulse control disorder

Clinical Features

A pattern of incomplete hair loss on the scalp of a person with trichotillomania
PMC3290022 crg-0006-0026-g01.png
  • Presents with bald spots in various sites: scalp, face, arms, legs, and pubic areas
  • Scalp is the most common, usually with associated eyebrow and eyelash involvement
  • Usually with bizarre-shaped patches of alopecia and different hair lengths due to breaking off at different points

DSM 5 Criteria

  • Recurrent pulling out of one's hair, resulting in hair loss
  • Repeated attempts to decrease or stop hair pulling
  • The hair pulling causes significant distress and impairment in at least one important area of functioning
  • The hair pulling or hair loss is not attributable to another medical condition
  • The hair pulling is not better explained by the symptoms of another mental disorder (eg, attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder)

Differential Diagnosis


  • Generally a clinical diagnosis, however skin biopsy can be used to exclude other etiologies of hair loss


  • Cognitive and behavioral psychotherapy is preferred over pharmacotherapy


  • Discharge

See Also

External Links