Trichotillomania Across Circuits: Neurobiology, Sensory Processing, and Genetic Insights
August 2025
TLDR Trichotillomania involves hair-pulling due to brain and genetic factors, with behavior therapy and new drugs showing promise, but challenges like stigma and underdiagnosis persist.
Trichotillomania, a distinct neurobehavioral disorder affecting 1-2% of the population, involves recurrent hair-pulling leading to hair loss and distress. This review highlights its unique neurobiological features, including dysregulated reward circuits, abnormal sensory processing, and genetic factors. Behavior therapy is the primary treatment, with new pharmacological approaches targeting glutamatergic and dopaminergic pathways showing promise. Technology-enabled interventions are also expanding treatment options. Despite advances, challenges remain in underdiagnosis due to stigma, limited provider training, and a lack of large trials. Future efforts aim to improve outcomes and address these gaps.