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Most people with trichotillomania pull out hair from their scalp, but some pull out hair from other areas, such as their eyebrows, eyelashes and genital area.

Most people with trichotillomania pull out hair from their scalp, but some pull out hair from other areas.

These include:

  • eyebrows
  • eyelashes
  • genital area
  • underarm area
  • arms
  • legs
  • chest or tummy
  • face, such as a beard or moustache

People with trichotillomania feel an intense urge to pull their hair out and growing tension until they do. After pulling their hair out, they feel a sense of relief.

A person may sometimes pull their hair out in response to a stressful situation, or it may be done without really thinking about it. 

Psychological symptoms

Trichotillomania can cause negative feelings, such as guilt. You may feel embarrassed or ashamed about pulling your hair out, and may try to deny it or cover it up. It can also make you feel unattractive and may lead to low self-esteem.

Trichotillomania may be a reflection of emotional or psychological distress, although the person with the condition may not always be aware of this.

For example, hair pulling may be a way of dealing with feelings of stress or self-loathing. In this way, it may be seen as a type of self-harm, where a person injures themself on purpose as a way of coping with emotional distress or anxiety.

Swallowing hair

Some people with trichotillomania chew and swallow the hair they pull out. This is known as trichophagia. Eating hair causes hair balls called trichobezoars to form in the stomach or bowel.

The hair balls can cause other symptoms, including:

  • feeling sick
  • vomiting
  • stomach pain
  • bleeding in your stomach, which can cause anaemia

Read more about the complications of trichotillomania.

Related conditions

Sometimes people with trichotillomania will have other related mental disorders, such as:

If the hair pulling takes place in response to a delusion (when you believe things that aren't true) or a hallucination (when you see or hear things that aren't there), you may have a different condition and should seek advice immediately from your GP.

Trichotillomania can be linked to other disorders, such as obsessive compulsive disorder (OCD). Visit your GP if you have repeated thoughts and urges you can't get out of your mind, or behaviours you have to repeat in a compulsive way.

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