Last Modified on Jan 07, 2014
What Is Trichotillomania?
A somewhat difficult to understand disorder, Trichotillomania is characterized by an individual’s irresistible urge to pull out the hair from his or her body including the scalp, eyebrows and other parts of the body. Known medically as trichotillomania, hair pulling often results in large patchy or bald spots. Even though the disorder is obsessive, affected individuals generally attempt to cover the habit and disguise areas from which they have pulled.
The signs and symptoms of trichotillomania are fairly straightforward. The characteristic symptom of the disorder involves the repeated pulling out of the hair from any part of the body paired with the urge to do so and a resulting relief after having pulled. Signs of the disorder include patchy bald areas on the scalp or other parts of the body and sparse or missing eyebrows or eyelashes. Additionally, individuals may exhibit other paired behaviors such as chewing or eating the hair that has been pulled out, playing with the pulled hair or rubbing the pulled hair across the lips or face. Individuals generally tend to pull in private and attempt to hide the results of their pulling.
While the cause of hair pulling disorder has not been identified, it is generally believed that trichotillomania arises as a result of several factors. Genetic and environmental issues are typically considered responsible for causing trichotillomania; however, irregularities in the typical chemicals in the brain, including serotonin and dopamine, may contribute to hair pulling disorder.
Natural Trichotillomania Treatment
While hair pulling is often considered an impulse control disorder, the underlying factors complicate the matter. Nonetheless, many natural treatment options are available that can facilitate treatment of the disorder and offer relief from its symptoms. Apple cider vinegar is a natural detoxifying agent that eradicates any underlying health issues that may be contributing to the disorder. Candor and n-acetyl cysteine are also helpful for treating hair pulling. Additionally, changing one’s diet to avoid sugar and processed goods helps treat any comorbid health concerns.
Apple Cider Vinegar
[YEA] 08/27/2007: Angela from Nashville, TN: "I originally found your website after I did a search for treating my reoccurring sinus infections. I began to take the ACV for a lingering cough after a sinus infection that just wouldn't go away. Immediately I felt like I could breathe better and I began to cough up the mucus in my chest. After a couple of days I noticed something else had changed about me. I've pulled hair out of my head for approximately 25 years and I hadn't pulled my hair out during those two or three days that I had been taking the ACV. It was so far from my mind that I didn't even realize I wasn't doing it! I then began to wonder if it was the ACV and I remembered a few years ago an article written by a man who's daughter suffered from hairpulling. He did some research and believed it was due to her scalp having dermititis...which is a fungus. I started to think that the ACV was getting rid of the fungus on my head, causing me not to pull. I am writing to you today to let you know that it's been three weeks since I've pulled a hair out of my head! This is amazing! I've never gone this long in my life without pulling out my hair, I'm so thrilled. Thank you so much for this miracle cure."Replies
02/05/2010: Jeanette from Hesperia, Ca replies: "Does the ACV really work for TTM? If so than I want to know is it in pill form or or liquid form. I want to know as soon as possible please tell me. I have suffered from TTM for over 18 years severely. i unfortunately pick at my eyelashes and eyebrows so I can't hide out in public. I hate it. It affects everything in my life."
02/08/2010: Bee from Anon, Usa replies: "To Jeanette- I am in the exact same situation as you- spent a lifetime pulling my eyebrows and eyelashes out- and still searching for a permanent solution! I haven't tried ACV longterm- but I have been taking N-Acetyl Cysteine 1200 mg/day with temporary success- though I have fallen into old patterns, although stress plays a huge role I think. I did use castor oil around my eyes and I wonder, if, in fact, fungus is the problem, if the castor oil helped that. Because I did have some success with the oil soothing the area which led to more pulling. Anyone with TTM knows that itching, gnawing feeling that you just have to pull certain hairs out. Without that itchy feeling, I pulled less. So I'm going back to rubbing castor oil into my eye area nightly, doesn't hurt if it gets in your eyes. Good luck to you in finding a cure and please share anything you find- I am still searching for a solution!"
05/05/2012: Anna from Annapolis, Md replies: "What really worked for me was a trich stop oil that I bought on line. It really helped with the itching and that insistent feeling that the follicles just needed relief. It's made of all natural oils so I felt good using it - no chemicals for me. I did use it with the kit that came with it that had some vizualisation, worksheets and journals. I do think that helped because you have to be ready mentally to stop as well. I think having the whole kit helped me attack it from several angles and now I've been pull free for quite awhile and feel strong and able to stay pull free. Good luck everyone!"
[YEA] 12/28/2009: Heather from Seattle, Wa, Usa: "After dealing with hairpulling on a daily basis for 8 years, I have finally found an end to the urge to pull.. I've been pull free for two months now, since I adopted an anti-fungal diet (no carbs, limited fermented foods, lots of meat, veggies, animal fats, lemon) and was put on anti fungal prescription meds by my ND. The urge to pull is completely 100% gone (just as it was for the 18 years before I began to pull), and my hair is growing back beautifully, if slowly.
Some may say that two months of success is too soon to post results, but I have had this experience occur for me in the past... Back in 06, I did the exact same diet/anti-fungal regime, and had the exact same results (no more hairpulling), but I didn't know what was causing the healing to take place.. I had been doing a strict no carb/anti-fungal regimen for 4 months (Doctor Supervised!!), was able to go hat-free after three months. I decided to take a trip overseas to celebrate my success, and after a week of drinking booze, eating carbs/candy, and staying up late, the hairpulling returned with a vengence. It's taken me two and a half years to pull up the courage to embark on this diet/lifestyle again. It can take a tremendous amount of commitment, planning, and resources, but quickly becomes a habit, and the results are sooooo worth it (try to avoid starting the diet during the holiday season... it's really tough to avoid all the treats. I ate some fruit and got a horrible detox rash on my belly). After the initial detox period, the diet is not hard to do, especially if you can wrap your head around Dr. Weston Price's nutritional principles. The slower you transition into the diet, the easier the intial detox will be on you (meaning no trips to the emergency-room with bizarre gastro-intestinal pain). If you drink soda or alcohol, be kind to yourself, and go really really slow. You have more work to do.
My hairpulling started at 18 when I went on birth control pills. my hair fell out in clumps when I ran my fingers through it, and then I just started to coax it out, which developed into trichotillomania. I was on other meds for ADD and depression at the time, as well as having used a copper-based shampoo/conditioner for many years (gave me a weird scalp rash occasionally). I was also living in a moldy dorm room. Never in my life had I pulled out my hair prior to this time, and the bcp seemed to be the catalyst.
Just for comparison, I want to list all the other treatment options I've invested in over the years, which haven't worked: two years of lenient vegetarianism, half a year of veganism, another half a year of raw foodism, 5 years of brain meds, two years of behavioral therapy, 6 years of psychotherapy, two years of neurofeedback, 4 months of neural therapy for tonsils (to treat PANDAS... worked for other stuff, did not help hairpulling), anti-fungal shampoos and coconut oil on the scalp, NAC, TTO, ALA (worsened hairpulling... mercury yeast connection??), sugar, alcohol, kefir and sourdough (Yeasts!)
PANDAS Theory has some weight to it (strep caused tic disorders), but is not the whole picture (for me at least). I probably had varying degrees of Pandas through out childhood, and I'm almost positive that it has been partially responsible for me acting to the bcp's the way I did... Gargling with salt water can help control the urge to pull sometimes, depending on how much sugar I've consumed.
I embarked on the no-carb diet in late october and was completely hairpull-free within two days (before starting on antifungals). After 8 years (give or take)of daily pulling, that is nothing short of a miracle.
So, to recap, hairpulling, for me, seems to be related to a fungal issue on the scalp and elsewhere within the body... google "John Kender and fungus" to see an "experts" view on the issue.(I'm 26... started pulling at 18.)
I hope this isn't too much oversharing, and that it helps someone!"Replies
12/29/2009: Bee from Usa replies: "Thank you so much for sharing, Heather. I have been trying the NAC and had some initial success but the holidays have been tough and I suspect the sugar and processed foods have made the TTM a lot worse. I've always felt like sugar is a big culprit and I have crave sweets and frequently have pulling episodes after I eat a lot of sweets. I've actually recently been looking into the research of Dr. Price- I'm happy to see it helps in this area as well! I'm hoping to change my diet in the next year for other health reasons- if I could also help the TTM I would be so thrilled!"
02/24/2010: Jenna from Fresno, Ca replies: "Heather! Thank you so much for your candor. I'm going to look into the ACV and a diet change immediately.
I'm 28 and don't know what is wrong with me. I've been pulling hairs out of my body for as long as I can remember, but it hasn't been until the last couple of years that I've felt out of control about it. I'm good at hiding, so I mess with my scalp or parts of my body covered by clothes. I also pick quite a bit at imperfections on my skin. In high school I got the feeling that I was more prone to ingrown hairs than other girls who never had issues with shaving. I'd fish out my ingrown hairs and then make things a lot worse. I'd get little pimples on my head and pull those hairs out. And then I have combination hair where some are really coarse, so I'd go find those. Now I'm sitting here with weird patches on my scalp. They're not too noticeable, but there everywhere. And all of these little, coarse hairs have started growing back and they stand straight up. I'm so so tired of deliberately pulling out hairs and justifying my reasons for doing so. I know they don't make sense, but I can't get my hands to stop. I'm also terrible with mosquito bites. Maybe our skin is just more sensitive than most. That's got to have some positive sides.
Anyway, aside from the straight TTM, I feel like there are more things that are related, especially if we're talking about fungus. Then--and I know this seems totally unrelated--I felt like I had a permanent UTI or something strange for about a year. I went to the doctor a few times, not an STD, and was either given antibiotics for a UTI or told that there was nothing wrong with me. THEN I had a really stressful time about a year ago and had this weird outbreak of folliculitus, mostly on my chest. Then a few months ago I was finally diagnosed with ADHD and am just now in the beginning stages of getting some perspective on my life--what's real and what's not. Anyway this was a really long way to say that I think all of it--not the ADD, just the weird health and TTM problems--is related to fungus. I'm starting ACV tomorrow.
Until tomorrow, I'll share something that has been a little beneficial. The only thing that I've noticed has ever helped me is fish oil. I've taken it off and on over the years for brain reasons, but have recently become more diligent because of the ADHD. I've found that the calm it gives my brain helps me to get my hands to listen to my head. I've also heard it has anti-inflammatory qualities which might help heal what I've broken. In Dr. Hallowell's ADHD books, he recommends up to 5000mg a day (make sure it's good enough quality that it does not contain mercury!) I try to take around that."
[YEA] 06/24/2011: Kitty from London, Ontario Canada replies: "I agree completely. My experience is that after going on an anticandida diet, one day I realized that I had not pulled for a number of days. After eating sugary or hi carb foods, the urge returns."
10/28/2009: Ch from Pdl, United States: "This is a very interesting thing on hair pulling, It was saying in a study done at the University of Mennesota. They gave half a group N Acetyl Cysteine and half a group placibo, and the half that took the N Acetyl Cysteine after 9 weeks of treatment dramatically reduced and was able to put the breaks on pulling their hair, the only thing they did not say was how much of the N Acetyl Cysteine that they took in the study. anyway this is where you can watch that video www.youtube.com/watch?v=yIrh4yd4Nus"Replies
10/29/2009: Bee from Usa replies: "I had posted asking about this not too long ago. The studies I read on pubmed had said dosages were from 1200-2400 mg. I have not yet tried it- but am seriously considering it- I would love to find a solution to this problem- sometimes I feel so defeated with this disorder- most people just wonder why I don't just stop pulling- but it's so much deeper than that- even on days I say I won't- inevitably it happens- next thing you know my eyelashes and eyebrows are bare. It's horribly frustrating and embarrassing. I would love to find something to help."
11/08/2009: Bee from Anonymous, Usa replies: "I decided to go ahead and purchase some N-Acetyl Cysteine- it's being shipped now. I purchased 600 mg capsules and will start on a regimen when I receive them. Will update with my progress- I really hope for good results since I have struggled with TTM since I was very young!! You don't find too many people out there that want to talk about this problem either- I admit I'm quite ashamed and embarrassed by it myself. Thanks again for this great website!!"
[BETTER BUT NOT CURED] 12/07/2009: Bee from Anon, Usa replies: "Just wanted to update on my progress with the NAC and Trichotillomania. I have been taking a dose of 1200 mg for just short of four weeks (the studies I read said best results were at 9 weeks). I am obviously not cured and still have some bad episodes of pulling. But it's worked well enough that I finally have some eyelashes growing back- and this is for me BIG progress. It's hard to see progress with this disorder because you can feel like your progress is completely ruined with one bad episode of pulling and you are back to square one- but I'm trying to realize it's not that big of a deal and it's not all ruined. I do have less strong of an urge to pull which is a new feeling and I assume it's the NAC since I haven't changed anything else. For most people this is a lifelong problem, so to see any progress makes me happy- I am going to continue on with the NAC and may even increase the dosage to 2400 mg- depending on progress further along."
[BETTER BUT NOT CURED] 02/19/2010: Anonymous from Washington, Usa replies: "HI I wanted to add something about N-ACETYL CYSTEINE ALSO KNOWN AS NAC (THATS WHAT SUPPLIMENT LABELS WILL ADVERTIZE AS). I HAVE BEEN PULLING OUT MY HAIR SINCE I WAS A KID AND NOW I AM ALMOST 30. I HAVE TRIED DEPPRESSION MEDICINE FROM A DOCTOR, I REALLY DONT THINK APPLE CIDER VINAGER WILL WORK...WHAT A JOKE, I HAVE TRIED NOT PULLING, I HAVE GOTTEN LONG NAILS PUT ON AT THE SALON TO MAKE IT HARD TO PULL, I HAVE TRIED COUNSELING SESSIONS, I HAVE ALSO TRIED A DIET CHANGE. ALSO I HAVE OBSESSIVE COMPULSIVE DISORDER WHICH MAKES IT WORSE. ABOUT TWO WEEKS AGO I HAVE STARTED TAKING 600 MG OF NAC TWO TIMES A DAY. IT IS FROM THE SUPLIMENT STORE ( COSTS ANYWHERE FROM 8 DOLLARS TO 30 DOLLARS DEPENDING ON WHAT BRAND YOU WANT ). I TAKE IT WHEN I GET UP IN THE MORNING AND I TAKE IT BEFORE I GO TO BED. THE REASON I AM POSTING THIS REPLY IS TO TELL THE DESPERATE PEOPLE OUT THERE WHO PULL THEIR HAIR OUT AND CANT STOP THAT THERE IS HOPE. MY CONDITION IS SO BAD THAT I, AN ATTRACTIVE COLLEGE STUDENT, AM ALMOST COMPLETELY BALD AND HAVE BEEN THIS WAY FOR YEARS. I WEAR REALLY EXPENSIVE WIGS THAT I SPEND ALL MY MONEY ON TO COVER UP THIS PROBLEM. MY WIGS LOOK VERY REAL. I HAVE DONE TONS OF RESERCH ON THE NAC SUPPLIMENT AND FOUND OUT THAT THIS SUPPLEMENT IS AMAZING AND EVERYONE IN THIS WORLD SHOULD BE TAKING IT. AT THE END OF THIS POST I WILL INCLUDE A WEBSITE THAT TELLS YOU EVERYTHING NAC IS GOOD FOR. THERE HAD BEEN VERY LITTLE RESERCH ON THIS HAIR PULLING DISORDER AND MOST MEDICAL PERFESSIONALS HAVE BASICALLY LABLED THIS PROBLEM AS UNCURRABLE. IT IS NOT FAIR. AND BECAUSE OF THIS DISORDER I AM AFRAID OF GOING OUT INTO THE WORLD BECAUSE I DONT WANT PEOPLE TO JUDGE ME IF THEY NOTICE MY WIG. ITS REALLY MESSED UP. I STAYED UP ALL NIGHT AND RESERCHED NAC AND FOUND OUT IT HAS BEEN USED TO HELP PEOPLE NOT PULL OUT THEIR HAIR OR AT LEAST DO IT LESS. I HAVE BEEN TAKING THIS SUPPLIMENT FOR TWO WEEKS AND I JUST REALIZED THAT I HAVE BEEN PULLING MY HAIR OUT WAY WAY WAY LESS. AS LONG AS I KEEP MY HAND AWAY FROM MY SCALP I WILL NOT PULL. BUT ONCE I START PULLING IT BECOME HARD TO STOP. BUT WITH TAKING THE NAC I HAVE NOT BEEN PULLING OUT MY HAIR AS MUCH AND I DONT EVEN REALLY THINK ABOUT DOING IT UNLESS I REMIND MYSELF. IT IS AMAZING. I MEAN SOME TIMES I CRY BECAUSE I CATCH MYSELF PULLING MY HAIR OUT FOR HOURS. I WILL UPDATE YOU ALL AND LET YOU KNOW IF I AM PULLING ANYMORE OR NOT. SO FAR WITH ONLY TAKING THIS FOR TWO WEEKS I HAVE PULLED LESS THAN I EVER HAVE. ALL I HAVE TO SAY IS WOW AND MAYBE THERE IS HOPE. AS SUGGESTED ON SOME WEB SITES, I MIGHT GO FROM TAKING 1,200 MG A DAY TO 2,400 A DAY. ONE OF THE WEBSITES YOU CAN READ ABOUT NAC FOR MANY CURES IS:
Trichotillomania or hair pulling treatment
N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study.
Arch Gen Psychiatry. 2009 July. Grant JE, Odlaug BL, Kim SW. Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN 55454, USA.
Trichotillomania is characterized by repetitive hair pulling that causes noticeable hair loss. Data on the pharmacologic treatment of trichotillomania are limited to conflicting studies of serotonergic medications. N-acetylcysteine, an amino acid, seems to restore the extracellular glutamate concentration in the nucleus accumbens. Fifty individuals with trichotillomania (45 women and 5 men were tested. Half received 1200-2400 mg/d of the supplement, and the other half placebo for 12 weeks. Patients assigned to receive N-acetylcysteine had significantly greater reductions in hair-pulling symptoms as measured using the Massachusetts General Hospital Hair Pulling Scale and the Psychiatric Institute Trichotillomania Scale. Fifty-six percent of patients "much or very much improved" with N-acetylcysteine use compared with 16% taking placebo. Significant improvement was initially noted after 9 weeks of treatment. This study, the first to our knowledge that examines the efficacy of a glutamatergic agent in the treatment of trichotillomania, found that N-acetylcysteine demonstrated statistically significant reductions in trichotillomania symptoms. No adverse events occurred in the N-acetylcysteine group."
01/01/2014: Brandi from Jacksonville, Florida: "I'm really worried about my son, Lucas. He's 18 months old and Hes got a really really weird obsession that started with him pulling my hair and putting it in his mouth when he was tired. Now he pulls his own and tonight in the bath I noticed a pretty huge bald spot starting in his head. My main concern is he actually EATS the hair after he pulls it out. He wraps it around his paci and sucks on it. (TMI) I can't tell you the amount of times I've found hair in his poop. What could this be?"Replies
01/01/2014: Taram7 from Cincinnati, Oh replies: "A quick Google search turned up trichotillomania and Trichophagia. Both are supposed to be mental/emotional disorders.... but my question would be has the child been vaccinated? Sometimes other issues can manifest as disorders and are difficult to determine what the reason is. My good friend babysat an autistic girl that was much older but had a hair eating compulsion due to her autism.... I know that is a highly controversial subject and have no clue what the situation is with yours, but I believe most things are curable in the natural world. "
01/01/2014: Mike 62 from Denver, Colorado replies: "Brandi: I have 3 siblings. We ate the same food and were raised in the same environment. They all ended up with functional families and were able to hold jobs. I was not. I was always nervous and had stormy chaotic thoughts. Recently I've become more calm and cognizant eating raw organic produce and taking the superfoods."
01/01/2014: Prioris from Fl replies: "Categorizing hair pulling as a mental disorder is just plain wrong. once you have had it and have been able to personally compare the mental states of when it IS happening and when it ISN'T happening, you would find out that the mental state is irrelevant. I think it is related to tourette syndrome but a borderline variety. I can't tell you why it physiologically happens but I think vaccines is one of the sources also."
01/02/2014: Mama To Many from Tennessee, Usa replies: "Dear Brandi,
It is hard on a mama to see our little ones suffer! My first thoughts, like those who have already posted, would be diet and vaccines. I would avoid all processed foods, MSG, food dye, artificial sweetener. You really have to be a detective to find it all. Even children's medications and juices have food dye and artificial sweeteners!
If you have access to a juicer, I would try and get him to drink 1/3 cup fresh organic carrot juice twice a day. Also, have him take an activated charcoal tablet (my toddlers will just chew them up.) at bedtime too slowly detox of anything.
I would avoid TV and computer for him for a time. I recall a number of years ago that there was a children's cartoon that actually was causing children to have seizures. The American Academy of Pediatrics recommends no screen time for children under two, anyway.
Is his pulling still when he is tired or is it more now? You might try an epsom salt bath before bed. (1 cup per bath.) It is relaxing and the magnesium is healthy. You could also try rocking him to sleep. You could get a soft blanket or stuffed animal to hold when rocking and if he tries to pull, have him stroke the animal or blanket instead.
Do you live in an older house? I am wondering about lead paint exposure.
I will be praying for you to have wisdom and Lucas to have healing. Please keep us posted.
~Mama to Many~"
01/02/2014: Nanowriter from Hotspot, Texas replies: "Brandi, I remember reading about horse foals eating the tail hair off other horses and it was some sort of diet deficiency, fiber if I remember correctly."