Anxiety hair pulling

Trichotillomania (hair pulling disorder) - NHS

Trichotillomania, also known as trich, is when someone cannot resist the urge to pull out their hair.

They may pull out the hair on their head or in other places, such as their eyebrows or eyelashes.

Trich is more common in teenagers and young adults.

Symptoms of trichotillomania

People with trich feel an intense urge to pull their hair out and they experience growing tension until they do. After pulling their hair out, they feel a sense of relief.

A person may sometimes pull their hair out in response to a stressful situation, or it may be done without really thinking about it.

Most people with trich pull out hair from their scalp, but some pull out hair from other areas, such as their:

  • eyebrows
  • eyelashes
  • genital area
  • beard or moustache

Bald patches on the head may have an unusual shape and affect 1 side of the head more than the other.

Trich may cause feelings of shame and low self-esteem. Those affected may try to keep their condition to themselves.

Causes of trichotillomania

It's not entirely clear what causes trich. It could be:

  • your way of dealing with stress or anxiety
  • a chemical imbalance in the brain, similar to obsessive compulsive disorder (OCD)
  • changes in hormone levels during puberty

For some people, hair pulling can be a type of addiction. The more they pull their hair out, the more they want to keep doing it.

When to see a GP

See your GP if you're pulling your hair out or if you notice that your child is.

You should also see your GP if you or your child has a habit of eating hair. This can cause hairballs to form in the stomach, leading to serious illness.

Your GP may examine areas where the hair is missing to check that nothing else is causing the hair to come out, such as a skin infection.

If your GP thinks you have trich, you may be referred for a type of treatment called cognitive behavioural therapy (CBT).

Treating trichotillomania

Trich is commonly treated using a type of CBT called habit reversal training.

This aims to help you replace a bad habit with something that's not harmful. Treatment usually involves:

  • keeping a diary of your hair pulling
  • working out the triggers for your hair pulling and learning how to avoid them
  • replacing hair pulling with another action, like squeezing a stress ball
  • loved ones providing emotional support and encouragement

Antidepressants are not are not usually prescribed to treat trich.

Things you can try yourself

Here are some tips from people with trich that may help when you feel the urge to pull your hair:

  • squeeze a stress ball or something similar
  • form a ball with your fist and tighten the muscles in that arm
  • use a fidget toy
  • wear a bandana or a tight fitting hat, such as a beanie
  • come up with a saying that you repeat out loud until the urge to pull passes
  • take a soothing bath to ease any stress or anxiety
  • practise deep breathing until the urge to pull goes away
  • exercise
  • put plasters on your fingertips
  • cut your hair short

Getting support

It may also help to open up about your trich to people you trust, as hiding it can sometimes make your anxiety worse.

Many people who have learned to manage their trich say that speaking to others about the condition led to a reduction in hair pulling.

The charity Trichotillomania Support has information on treatments and self-help advice.

Page last reviewed: 29 January 2021
Next review due: 29 January 2024

What Is Trichotillomania? WebMD Explains Hair Pulling

Written by WebMD Editorial Contributors

In this Article

  • What Is Trichotillomania?
  • Trichotillomania Symptoms
  • Trichotillomania Causes and Risk Factors
  • Trichotillomania Diagnosis
  • Trichotillomania Treatment and Home Remedies
  • Trichotillomania Complications
  • Trichotillomania Prevention

What Is Trichotillomania?

Trichotillomania, also known as “hair-pulling disorder,” is a type of impulse control disorder. People who have trichotillomania have an irresistible urge to pull out their hair, usually from their scalp, eyelashes, and eyebrows. They know they can do damage but often can’t control the impulse. They may pull out their hair when they're stressed as a way to try to soothe themselves.

Trichotillomania is a type of impulse control disorder. People with these disorders know that they can do damage by acting on the impulses, but they cannot stop themselves. They may pull out their hair when they're stressed as a way to try to soothe themselves.

Trichotillomania Symptoms

Besides repeated hair pulling, other symptoms may include:

  • Feeling tense before pulling hair or when trying to resist the urge to pull hair
  • Feeling relieved, satisfied, or pleased after acting on the impulse to pull hair
  • Distress or problems in their work or social life due to hair pulling
  • Bare patches where the hair has been pulled out
  • Behaviors such as inspecting the hair root, twirling the hair, pulling the hair between the teeth, chewing on hair, or eating hair
  • A preference for certain types or textures of hair

If you have trichotillomania, you could also have other disorders that often come with it, like onychophagia (nail biting) or skin picking disorder. Pulling fibers from blankets or hair from dolls are other signs you could have trichotillomania.

Many people who have trichotillomania try to deny they have a problem and may attempt to hide their hair loss by wearing hats, scarves, and false eyelashes and eyebrows.

Trichotillomania Causes and Risk Factors

The exact cause of trichotillomania isn't known. It may be related to changes in brain pathways that link areas involved in how you manage your emotions, movement, make habits, and control your impulses.  

Some things may boost your risk of trichotillomania, including:

  • Age. Trichotillomania usually starts in the early teens, between ages 10-13. It can last throughout life, though symptoms may come and go.
  • Genes. In some families, the tendency to trichotillomania may be passed on. It’s more likely if another family member has it.
  • Other mental health disorders. If you live with trichotillomania, you may have other mental health problems, such as anxiety, depression, or obsessive-compulsive disorder (OCD).
  • Stress. Extreme stress may trigger trichotillomania in some people. Stress can be triggered by situations including family conflict, abuse, or the death of a friend or family member.

Trichotillomania Diagnosis

Trichotillomania is diagnosed based on its symptoms. There’s no specific test for it.

A doctor might refer someone who has symptoms of trichotillomania to a psychiatrist or psychologist, who can interview the person and see if they might have an impulse control disorder.

Trichotillomania Treatment and Home Remedies


Many types of therapy can support people with trichotillomania and even help them stop hair pulling completely.  

  • Acceptance and commitment therapy. You’ll be able to practice accepting the hair-pulling urges without actually hair pulling.
  • Habit reversal. This is often the main treatment for trichotillomania. It’ll help you  practice other, less harmful habits instead of hair pulling, like clenching your fists when you have the urge to pull your hair.
  • Cognitive therapy. This helps people explore and change the beliefs that lead to hair pulling.


There are no FDA-approved medicines for trichotillomania, but these drugs may control symptoms in some people:

  • Antidepressants
  • Atypical antipsychotics
  • N-acetyl-cysteine, an amino acid supplement

Trichotillomania Complications

Trichotillomania can cause great distress to people who have it. Many say they feel shame and  embarrassment, and they often have low self-esteem. Other complications can include:

  • Problems at work and in social settings. People with trichotillomania may shy away from social situations and friendships and even turn down job offers because they’re embarrassed about pulling.
  •  Skin and hair damage. Constant tugging can leave scars on the scalp and affect hair growth long-term.
  • Hairballs. These are large, matted wads of hair called trichobezoars that form in the GI tract. Over time, they can cause weight loss and blockages.

Trichotillomania Prevention

There is no proven way to prevent trichotillomania, but getting treatment as soon as symptoms start can be a big help. Learning stress management is also a good idea, since stress often triggers hair-pulling behavior.

Anxiety & Panic Disorders Guide

  1. Overview
  2. Symptoms & Types
  3. Treatment & Care
  4. Living & Managing

“I dragged my hair and yelled obscenities”: a monologue of a girl who survived domestic violence from her mother

, 22 years old, Moscow

“My upbringing was like training”

When I was born, my mother was 18 years old, and my father was 17. I was an unplanned child: they were still studying at the university and lived in a hostel. Both had an explosive nature, and therefore quarrels between them happened often. Sometimes it even came to physical violence: in a fit of anger, for example, they could tear each other's clothes or fight. Since childhood, I have watched their abuse, so early on I began not only to absorb the culture of violence, but also to feel it myself.

When I was four years old, they divorced and I stayed with my mother. Since childhood, I have shown interest in learning and almost immediately became an excellent student at school. Noticing this, my mother decided to be strict and decisive in all matters related to my education. For example, I couldn’t do my homework on my own: after school I wrote it in draft form and only after my mother checked it, I copied it into a school notebook. I really didn’t like it: I could come from school before lunch, do everything in an hour and go for a walk until the evening, but in the end I waited for my mother from work and then rewrote everything I checked. If I badly rewrote my homework into a clean copy, then my mother would start yelling at me and tearing up my notebooks. Then I had to start new ones and rewrite not only the last task in them, but also all the previous ones, including classwork. When angry, she never hesitated in expressions. She could say nasty and terrible things to me, and I absorbed them, thinking that I deserved them.

Because of this, since childhood, I was very afraid of my mother. I was scared that she would slap me, hit me, tear my notebook and punish me. Sometimes fear really drove me. For example, I liked to do my homework while sitting on the floor, and my mother really didn’t like it. As soon as I heard the turn of the key in the door lock, I ran at full speed to the desk and threw all the notebooks there so that she would think that I was studying there. I understood that if she saw that I was sitting on the floor with homework, she would simply beat me up.

My upbringing was reminiscent of training: my mother communicated with me using the carrot and stick method, and in most cases she preferred the former. Although she tried to be perfect in material terms and provided me with everything I needed, in a spiritual, moral aspect, she missed me, laying in me a lot of fears. The worst episodes happened when my mother lost her temper: she could drag me by the hair around the house, yell at me if I violated her rules. Moments like these made me want to go to my father.

“I had nowhere to put my anger and resentment inside me, so I hurt myself.”

The relationship between my parents was always bad. Dad was neither a good husband nor a good father: I managed to establish contact with him already at an older age. However, he tried to help me. I remember how, when I was seven or eight years old, we once again had a fight with my mother. During the quarrel, there was a fight between us, and dad decided to take me away. I wanted to pack my things before my mother came and go to him. But she returned from work earlier than we expected. When she saw me packing my bags, she started hysterical: holding me at the doorway, she shouted to the neighbors: “Call the police, she is being kidnapped!” Then she looked into my eyes, still not letting me move, and said: “If you cross this threshold now, you will never see me again, don’t even dare to come back here. ” I was frightened: despite all the desire to move in with my father, I was afraid of losing my mother. Dad did not interfere - if he had come into conflict with her, she would have done everything to make him lose any connection with me.

As a child, I was more aware of physical abuse than emotional abuse. The latter I began to understand in adolescence.

Our life together became unbearable: my mother continued to beat me, and after one of the quarrels, she told me a phrase that I remembered for the rest of my life: “You have a disgusting character, you are such scum that you will die alone.”

High school was a nightmare for me, and I was counting down the seconds before entering the university in Moscow just to move out. When I was in the 11th grade, my mother got pregnant by my stepfather. Then we had a conflict on domestic grounds: she did not like how I cleaned the house. She was always obsessed with cleanliness, and any crumb on the floor became a cause for scandal. That conflict again turned into violence: she beat me, and I could not defend myself - what if something happens to her child. She not only beat me, but also took away the phone and said that phrase about my character. That was the first time I had suicidal thoughts. But the desire to live won: I understood that when I moved, everything would be different for me and everything would work out. Then I just sat down by the battery and began to sob with all my might and beat my head against the wall. I had nowhere to put my anger and resentment inside myself, so I hurt myself , scratching my hands from my hands to my shoulders until they bleed.

“Our relationship was like a roller coaster”

Constant conflicts with my mother led to the fact that I always feel guilty about everything that happens in my life. After the scandals, we could not communicate for several weeks: my mother just walked offended and waited for me to crawl on my knees to apologize. I have done this for most of my life, although I have not always been really guilty.

I always cried during our quarrels - this was my defensive reaction to the terrible words she said to me. Until now, I talk to my parents like a little girl: even now, years later, after any skirmish with my mother, I sob and cannot stop. When my mother saw my tears, she said that she should cry, not me, because she had a bad daughter. My stepfather tried to reconcile us when he realized that we had been ignoring each other for too long, but he did not go into direct conflict with my mother, and constantly reminded me of what I owe her. This only increased the feeling of guilt, which I am trying to overcome today with a psychologist.

My relationship with my mother improved briefly after the birth of my younger brother. When we were not arguing, I could share a lot with her: I talked about my personal life, asked for advice. At such moments, we really had a trusting, good relationship, but as soon as a quarrel was brewing or her mood changed, she directed against me all the good that I shared with her. Our relationship was like a roller coaster: positive moments were abruptly replaced by negative ones, and it seemed that there would be no end to this.

Having entered Moscow and left home, I realized that the past would not let me go. Studying was not easy for me: being away from my mother, who kept me in strictness and fear, I felt freedom, I wanted to rebel. I lacked the usual kick and control from her to take up my education. After the second year, I came to visit her: we quarreled again, and she threw a toy concrete mixer at me. She weighed decently - almost eight kilograms. I realized that this is the end and I've had enough: such relationships need to end.

“A child should not feel the pain that I felt”

After several years of living in Moscow, I turned to a psychologist. Relations with my mother became unbearable, problems with studies continued. In addition, I met with a young man who also showed emotional abuse towards me. I couldn't leave him - I thought that the pain he causes doesn't give me the right to live without him. I grew up in a culture of violence and got into a relationship where I was not appreciated, offended and humiliated, and I only became more attached to this person. In this situation, it seems that you love each other even more if your partner treats you badly. I held on to these relationships, I was afraid to lose them - it was exactly the same with my mother. When I saw that the violence from my boyfriend was becoming regular, I realized that it could not continue like this.

Often I ask myself, “Do I love my mother at all?” After all, she has something to love and something to hate. I can’t say for sure that I love her, but I can’t say with certainty that I don’t. Communicating with a psychologist, I realized that people who show emotional or physical abuse are, to some extent, victims themselves inside. Victims of violence, dislike, misunderstanding, rejection. They are not born that way, they become because someone they loved failed to teach them how to do it right.

I used to try to justify the actions of these people. In such situations, at some point you lose your sense of reality: at first you don’t understand why they are doing this to you, then - and this is the worst thing - you start to get used to it and think: “Probably I deserve it.”

I justified my mother by the fact that she had a difficult childhood, in which she was not given enough love. In the same way, I explained the behavior of my boyfriend. Mom still does not understand how hard it was for me then and what damage she caused to my health. Every time I want to explain it, she takes everything with hostility and tries to compete with my father: "He's good, and I'm the only bad one." She does not try to listen, it is very hard for her. If I have children, I want them to be emotionally healthy and not have the experience that I or my mother had. I understand that there are no ideal families, but a child should not feel the pain that I felt.

From time to time, I myself can show some kind of cruelty - the experience I have experienced makes itself felt, it does not leave without a trace. I am emotional: I can scream or say something bad, but I always stop because I understand that now I am behaving like my own mother, and I don’t want to be like her for anything. I am working on becoming a different person, and I am succeeding.

My main advice to those who find themselves in a similar situation: in no case should you take the opinion of an abuser as an authority, even if it is your relative, parent, in a word, someone who is higher in some hierarchy. Do not believe the words of this person, even if he is the closest to you. His words are a projection of his personal problems . And the worst thing is to realize that because of them your mother simply does not know how to love you in return.

“Children who grew up in violence need to return to their real selves, to understand that they are valuable in themselves”

Abuse of a child leads to very serious consequences. From my own experience, I can say that physical violence can be tolerated more easily than emotional violence, because the second is not labeled as violence by either the child or the adult himself, but is perceived as natural. In the context of physical punishment, the pain inflicted on children can be perceived by the parties as love.

This is dangerous because the closest people - mom or dad - show the child that only through pain can love be expressed. But the human psyche is built to avoid pain, and that is why many children who were abused in childhood, especially emotionally, grow up alienated, do not let anyone near them and do not trust anyone. This happens because any contact with feelings raises the pain that was in childhood, when the closest people acted so badly.

In cases of domestic violence, it is important for a child to find a group or person who will help him see a different attitude towards himself. It could be a teacher, a coach, or someone else who makes the child feel loved unconditionally. When there is violence, there is no chance to get a different experience of relating oneself with the world, and the one that is available seems to be the only possible one.

When you are beaten, you are ready to leave home. However, when a child, especially a small one, tries to leave the family, he realizes that there, in the big world, no one is waiting for him.

Children who have experienced domestic violence do not realize that they are ready to be accepted as they are. They try to conform to some image, what others want to see.

For those who could find themselves in a similar situation, I would advise working with a psychologist who will help restore and build boundaries. Children who have experienced emotional abuse easily escape into their own thoughts: they begin to live in the future, thinking about what they will be someday, but not now (“Here I will become rich, and my mother will love me”), or live in the past ( “Mom offended me, and dad said hurtful words”). It is important to feel here and now, and not anywhere else.

Children who grew up in violence need to return to their real selves, understand that they are valuable in themselves, work on the injuries received, and only after that come into contact with their parents. It’s worth restoring relationships from short moments of communication (phone, SMS) - even if the usual negative reaction is received in response, you should try to focus on what you managed differently this time: for example, react more calmly to the negative or decide which something problem without conflict. A person can expect praise from parents, but one must live one's own life without thinking what kind of response you will receive.

Until the age of majority, the legal representatives of the child are his parents or one of them. There are only two exceptions: when a child enters marriage after 16 years of age or when he is emancipated (recognition by the guardianship authorities of the child’s full legal capacity and his independence from adults. - Note ed. ).

In a situation of violence for a minor victim, it is important to understand that on the basis of Part 2 of Art. 56 of the Family Code of the Russian Federation the child has the right to protection against abuse by parents or persons replacing them . There are several grounds for such protection: violation of the rights and legitimate interests of the child, improper fulfillment or disregard for upbringing duties, abuse of parental rights, etc. Until the age of 14, the child has the right to independently apply for protection to the guardianship and guardianship authorities, and after receiving a passport - to court.

If the infliction of violence is proven, then it is possible to raise a question in court on the deprivation of parental rights on the basis of 69th article of the Family Code of the Russian Federation. According to this article, parents (or one of them) may be deprived of parental rights if they abuse their parental rights: they abuse children, including physically or mentally abuse them, encroach on their sexual integrity. Evidence is required to terminate parental rights. They can be video materials, photographs, audio recordings or testimonies of witnesses. In addition, a psychological examination may be required.

“I pulled my hair. Poured cold water into my ear. During pregnancy he called me a snake. Basilashvili's ex-wife speaks about the bullying of a tennis player

Nikoloz Basilashvili / Photo: © Li Yibo / Xinhua / Global Look Press

The ex-wife of the 34th racket of the world, Georgian Nikolos Basilashvili, Nelly Dorokashvili, testified in a domestic violence case, she said that she seriously recognized her husband only at the wedding, when he first used violence against her.

- We met in 2011, after a year and a half we decided to get married. They officially got married in September. Talking about our relationship is emotional for me, but I will try to remember all the facts of living together. Very soon I found out that before the wedding I actually met with a completely different person.

What was very unexpected for me: on the wedding day, when a woman should be happy, I did not experience joy. On their wedding night, Nikolos' mother was angry and quarreled with him. Nikolos sat down at my table and grabbed my arm under the table. It was very painful, I didn’t understand at all what was happening - when your spouse is sitting next to you and doing something like that. I asked what was going on, but he did not answer.

I remember how her mother got up and left our wedding. At the time, I didn't consider it violent, but it was the first time and it was emotionally difficult. This was not the case before. Before we did not live together, we walked in the park for an hour or two. On the day of the wedding, I found out that I was dating another person,” Dorokashvili said at the trial.

According to the victim, frequent psychological and physical violence against her began 5-6 months after the wedding and did not stop even during pregnancy.

— In 2015, we had a baby. I remember that I spent most of my time during my pregnancy alone. Although I had a healthy pregnancy, Nikolos felt that I should be at home. I listened to him. Nikolos arrived the day after giving birth. ..

5-6 months after the wedding, they began to humiliate me, treat me in a derogatory manner, this was followed by cases of physical violence... Once I lay down on the bed after the conflict, and they poured cold water into my ear when my eyes were closed. Violent actions were of a different nature: pulling hair, he threw food ... When he achieved some success, he announced to me that he was now the king, and I should behave like his subject, ”the victim said.

- I constantly had to start talking about divorce, I said that I would go to the police if he did not stop the violence. At the same time, he told me that his mother believes that after giving birth, women go crazy. During pregnancy, he constantly called me names - a rat, a snake, a flea. He also called my relatives names, - Radio Tavisupleba quotes Dorokashvili.

Basilashvili was arrested by the police on May 22, 2020. He was charged with physical abuse of his ex-wife in the presence of a minor child. Later, the prosecutor's office clarified the charges against Basilashvili.

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