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What is trichotillomania?

Trichotillomania is an anxiety response where the person tries to regulate themselves, or feel better, by pulling out their hair or picking their skin.

They might pull hair out of their head, their eyebrows or their eyelashes. They might pull scabs, arm hair, pubic hair or hangnails.

Trichotillomania is difficult because the person doesn’t realize they are doing it. They will say things like, “I suddenly became aware there were long hairs all over my homework.” 

If the people around the person point out the behavior, the person feels more anxious and is more dysregulated.

Trichtillomania often occurs at puberty therefore it likely has a hormone related component.

What kinds of things can you do?

  1. Understand that it’s a response to anxiety and a way to cope. Nothing else. It’s a way to regulate themselves.
  2. Don’t do things to increase anxiety like ask, “Why are you doing that?” or “Well, stop doing that!” “Oh, look you are pulling!
  3. Do help them find other ways to calm down by engaging in those activities with them. Music, sharing feelings, reading, playing with figit spinners or Play Doh, rubber bands or hair ties they snap. Gently redirect to a more positive behavior without pointing out the hair pulling. “Let’s listen to Twenty One Pilots”.
  4. If they are wanting help, find ways to help them block access to the hair. Gloves, hats, painted fingernails they don’t want to mess up, wearing hair in a ponytail or a messy bun.
  5. You can even work with the school so that the child has a 504 plan. The plan can include them wearing a hat or cotton gloves. Maybe they get to carry a figit toy. Hats and ponytails work really well when someone is pulling the hair out of their head. Gloves can work when they target their eyelashes. Make up like mascara can be a trigger for some people or it can be a deterrent that makes them NOT pull eyelashes.
  6. When the person you want to help is ready, you could order them books to help understand trichotillomania. We say “when they are ready” because putting books in their face can also be a trigger that says, “Fix this!” You don’t want that energy. But if they want a book, one such book is here:  BOOK
  7. Tracking the hair pulling can help. Having a tracking sheet or app on their phone and they mark their sheet whenever they notice the hair pulling. This helps create mindfulness around the hair pulling. It gets them out of the trance. There are trichotillomania apps to help them track.
  8. Recognize that sometimes, though, tracking, reading or watching videos can have the opposite effect. It triggers the person to REMEMBER their addictive pattern and increases the urge. In that case, you will have to be creative in other ways to distract them.
  9. Be patient and gentle. Let them lead the healing process. It’s not something that needs an immediate fix. It’s not a sign of anything other than one of the many many ways human beings try to cope. It’s often a sign of a sensitive, intelligent, tuned in and creative person.


If your teen wants the help of a therapist to assist them in learning anxiety coping skills, we have a team who can help. Having an outside helper can be beneficial. We have a team of excellent listeners who understand anxiety and trichotillomania.


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Free Clear Mind Therapy provides in-person therapy in Fishers & Indianapolis and online therapy across Indiana. Specializing in anxiety therapy for teens, adults, and kids.

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