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Trichotillomania (TTM), also referred to hair-pulling disorder, involves intense and recurrent urges to pull out hair from the scalp, face, extremities or other parts of the body. These urges are highly distressing and are often reported as impossible to ignore. The pulling habit can lead to patchy spots of hair loss especially when the pulling is directed at the scalp. Shame and embarrassment are common, and most people with Trichotillomania go to great lengths to keep the habit concealed. Trichotillomania is part of a larger group of habits called body-focused repetitive behaviors or BFRBs. 

Additional Symptoms of TTM:

  • intentional or mindless pulling

  • pulling can be in response to specific thoughts ("I need to get rid of the coarse ones") or emotions (boredom, anxiety, calm)

  • hair loss or thinning at the site of pulling

  • urges that precede the pulling, often described as tension

  • relief upon pulling

  • post-pulling rituals include examining, biting or chewing the hair

  • twisting or playing with the hair after its pulled out

  • rubbing the hair on the lips or face

  • repeated efforts to resist the urge to pull are largely unsuccessful

Other BFRBs:

  • skin picking (Excoriation Disorder)

  • nail biting (Onychophagia)

  • hair eating (Trichophagia)

  • lip biting

  • cheek chewing

  • tongue chewing

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