Trichotillomania

Trichotillomania is a behavioral disorder characterized by the recurrent failure to resist removing one's own hair from the scalp, eyelashes, eyebrows, beard, axillary areas or pubic area. Patients report an increasing sense of tension immediately before the impulse to pull out their hair and a sense of gratification or relief during the act. On initial presentation, patients may deny that their hair loss is due to such behavior. The diagnosis of trichotillomania is excluded when there is a preexisting skin disorder or when the behavior results from underlying psychosis. Behavior modification training, psychotherapy, hypnosis and family counseling are common treatment approaches. Antidepressant medications such as amitriptyline and clomipramine are effective when depression or an obsessive-compulsive disorder coexists.

U.S. Air Force Hospital Nellis, Nellis Air Force Base, Nevada.