The Clinical Characteristics, Neurobiology, and Treatment Options for Trichotillomania

Abstract

Trichotillomania is characterized by the compulsive act of pulling one's own hair, leading to hair loss and potentially causing functional impairment. Trichotillomania, a psychiatric disorder characterized by the compulsive need to pull out one's own hair, has been documented in the medical literature since the 19th century. Based on prevalence surveys, trichotillomania exhibits a notable presence throughout the population, with point prevalence estimates ranging from 0.5 to 2.0 percent. Trichotillomania, as delineated in the Diagnostic and Statistical Manual of Mental Disorders-5, is categorized as an obsessive-compulsive disorder (OCD); nonetheless, it exhibits notable distinctions from OCD across various dimensions. For instance, the use of habit reversal therapy and the administration of drugs like n-acetylcysteine or olanzapine are common ways to treat trichotillomania. It is important to note that these treatment approaches are not typically employed for the treatment of obsessive-compulsive disorder (OCD). In contrast, it appears that specific first-line medications for obsessive-compulsive disorder (such as selective serotonin reuptake inhibitors) do not demonstrate efficacy in treating trichotillomania. This article provides an overview of the existing body of knowledge pertaining to trichotillomania, a psychiatric disorder characterized by compulsive hair pulling. It also examines the available empirical evidence that supports various treatment approaches for this condition.