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

Trichotillomania, affecting 1-2% of the population, is a neurobehavioral condition involving repetitive hair pulling, now recognized for its unique features distinct from OCD. A literature review from 2000-2025 identified three major research directions: dysregulated reward circuits, abnormal sensory processing, and genetic factors, which have informed treatment advances. Behavior therapy remains the first-line treatment, with new pharmacological approaches targeting glutamatergic and dopaminergic pathways showing promise where SSRIs have not. Technology-centered interventions are also expanding treatment options. Despite these advances, challenges such as stigma-driven underdiagnosis, limited provider training, and insufficient data persist, highlighting the need for an integrative approach to improve outcomes and address care gaps.