Trichotillomania

Trichotillomania is a behavior disorder seen in both pediatric and adult populations that involves the pulling out of one’s own hair. It was described originally in 1889 by the French dermatologist Hallopeau. Many young children who pull their hair outgrow the habit without any major intervention and are not classified as having true trichotillomania. The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) classifies trichotillomania as an impulse control disorder that is similar to kleptomania and pyromania, but there are some who argue that it is categorized more appropriately as an obsessive-compulsive disorder. To meet the DSM-IV diagnostic criteria, a patient must feel rising tension just prior to hair pulling or during attempts to resist pulling and must experience a sense of pleasure or relief during or after the behavior. Whether these criteria are always met in children is difficult to determine. Moreover, the strict definition may exclude patients who are in need of and may benefit from therapeutic intervention.

The prevalence of trichotillomania has been estimated variably in different studies, ranging from one report of a lifetime prevalence of 0.6% using the strict DSM-IV criteria to another estimate that 4% of the general population are hair pullers and 10% have had the habit at some point in their lives. Trichotillomania is more common among children than adults and …