Trichotillomania Across Circuits: Neurobiology, Sensory Processing, and Genetic Insights

This review on trichotillomania, a condition characterized by repetitive hair-pulling, highlights its unique neurobiological and genetic features, distinguishing it from obsessive-compulsive disorder. Affecting 1-2% of the population, trichotillomania is often underdiagnosed due to stigma and lack of awareness. The review identifies three major research directions: dysregulated reward circuits, abnormal sensory processing, and genetic factors, which have informed treatment advances. Behavioral therapy remains the primary treatment, with new pharmacological approaches targeting glutamatergic and dopaminergic pathways showing promise. Technology-based interventions are also expanding treatment options. Despite these advances, challenges such as stigma, limited provider training, and insufficient data persist, necessitating further research and improved care strategies.