Trichotillomania: What Do We Know So Far?

Trichotillomania is an obsessive-compulsive disorder where patients compulsively pull out their hair, affecting mainly females and presenting as nonscarring patchy alopecia. It is estimated to affect 0.5–2% of the general population, but the actual prevalence may be higher due to the associated shame. Treatment requires a comprehensive, interdisciplinary approach. Behavioral therapy, particularly cognitive-behavioral therapy (CBT) and habit reversal training (HRT), has shown success, and new technologies that monitor habits may enhance its effectiveness. Pharmacotherapy, including tricyclic antidepressants, selective serotonin reuptake inhibitors, and glutamate-modulating agents like N-acetylcysteine, may also be necessary. However, no medications are specifically approved for trichotillomania, and their efficacy varies. Social support is a significant factor in successful treatment, and negative feedback or punishment for hair pulling is not effective.