Trichotillomania: An Impulse Control Disorder

The document discussed trichotillomania (TT), an impulse control disorder where individuals have a compulsive urge to pull out their own hair, affecting approximately 8 million Americans, predominantly children, with onset at 8 years for males and 12 years for females. TT is characterized by distinct alopecia patterns without skin inflammation and can be diagnosed through histological features like distorted follicular anatomy and pigment casts. Treatment typically involves a mix of drug and behavioral therapies, particularly for cases lasting over three months. Histological signs of TT include incomplete follicular anatomy, trichomalacia, pigment casts, and peri- and intrafollicular hemorrhage, with diagnosis relying on both clinical and histological evaluations.