For the few people out there, who know what trichotillomania is, their knowledge is limited, and they may not fully understand the condition. They know it has something to do with pulling out your hair. But they don’t know what causes it. And they don’t know that it’s an uncontrollable compulsion.

The vast majority of people, however, have no idea what trichotillomania is. This leads to misunderstanding and misconceptions about this very real condition that affects over 2% of the population. The social stigma of the condition is perpetuated by their lack of knowledge and understanding.

Here are some things you might not know about trichotillomania.

1. Hair pulling is not limited to the scalp

Many trichotillomania patients do not pull out their head hair. They pull out their eyebrow hairs, eyelashes, facial hair, body hair, and pubic hair. In some cases, they pull hair out in these areas to the extent that it doesn’t grow back. This leaves them permanently marked by trichotillomania.

Statistical research suggests that 86% of sufferers pull hair out of their scalps, while 52% pull out their eyelashes. 38% pull out their eyebrows, and 27% pull out pubic hairs. Only 18% of sufferers pull hair out of their legs.

Some sufferers tend to focus on pulling out hair in a certain place. Others pull out whichever hair they can access at the moment the urge overtakes them. However, at some stage, the majority of trichotillomania patients will report pulling hair out of their scalps.

2. Trichotillomania is treated with cognitive behavioral therapy

Cognitive behavioral therapy is used in the treatment of trichotillomania as patients need to alter their responses to situations. This is done in conjunction with therapy that determines the causes of the condition. Once a therapist has established what makes the person pull their hair out, effective treatment is possible.

Cognitive behavior therapy in conjunction with certain medications allows the patient to start their journey toward recovery. Patients are taught techniques to help them cope when confronted with the uncontrollable urge to pull their hair out. There are also resources such as TrichStop. This site offers online support and advice.

3. Trichotillomania is a compulsive disorder

Contrary to popular belief, trichotillomania is not something a sufferer can just stop doing. The urge to pull hair out is overwhelming. The person feels compelled to pull out their hair, and virtually nothing can stop the urge.

Sufferers have different triggers that cause them to start pulling out their hair. For some, it’s a calming mechanism. For others, it provides a sense of satisfaction.  There are those who can’t report what it is that makes them do it. If a person has not be taught to address their specific triggers constructively, the need to pull hair out persists.

Understanding that it’s not a choice is one of the most important things you should know about Trichotillomania. When you understand that it’s not a chosen behavior, you can be more supportive of a patient.

4. Trichotillomania does not have one specific cause

Trichotillomania is not triggered by stress or anxiety in all cases. There are several factors that may contribute to a person developing the disorder. Certain people are more at risk than others of trichotillomania. If you have a relative with trichotillomania or any other Body-Focused Repetitive Behavior (BFRB), there is a chance you could get it too. People with a history of Obsessive Compulsive Disorder (OCD) or mood disorders such as depression also face a greater risk. Patients with these conditions have trouble regulating their emotions, and this may trigger behaviors such as trichotillomania.

Traumatic circumstances during your upbringing or life events that have caused trauma can also predispose you to get trichotillomania.

The fact that many people develop the condition between the ages of 9 and 13 is also cited as a pointer for hormonal disturbances as a cause of trichotillomania.

5. There are different types of trichotillomania behaviors

For the first group of trichotillomania patients, hair pulling is a conscious effort. They pull their hair out by choice. They often seek out what they perceive to be imperfect hours. They take the time to find these hairs and pull them out. It gives them a sense of control. Many find it satisfying and relaxing.

The second group pulls their hair out without even realizing it. Many do it in their sleep.  Even for those who do it while awake, they aren’t aware of what they are doing until they see the damage done afterward. They enter a trance-like state during the hair pulling.