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Trichotillomania Defined

Cassie Ammerman, Publicity Assistant

Douglas W. Woods is associate professor of psychology and Director of Clinical Training at the University of Wisconsin-Milwaukee. Dr. Woods is a recognized expert in assessment and treatment of trichotillomania, Tourette Syndrome, and other obsessive-compulsive disorders. Michael P. Twohig is assistant professor of psychology at Utah State University in Logan, Utah. His research has generally focused on the treatment of OCD and OCD spectrum disorders such as trichotillomania and skin picking. The excerpt below is from their book Trichotillomania: An ACT-enhanced Behavior Therapy Approach, from the Treatments That Work series, explaining what trichotillomania really is.

What is Trichotillomania?

Trichotillomania, or TTM, is chronic hair pulling resulting in noticeable hair loss. Individuals usually feel an increasing sense of tension immediately prior to pulling out the hair or when attempting to resist pulling and feel a sense of gratification when pulling hair. Individuals typically experience significant distress or impairment in important areas of their life due to their struggles with the urges to pull and the hair pulling itself.

The places people most commonly pull hair from are as follows:

  • Scalp
  • Eyebrows
  • Eyelashes
  • Beards
  • Pubic hair


Research estimates are limited, however, it is speculated that somewhere between 10% and 15% of young adults pull hair, but only 2% to 3% experiencing noticeable loss and significant distress from pulling. Thus, hair pulling may occur on a continuum, ranging from benign hair pulling to more severe pulling that results in noticeable hair loss and distress.

Gender Differences

Many more adult women present for trichotillomania treatment than men. This difference may only account for the number of people seeking help rather than actual differences in rates of trichotillomania. For example, in children the gender distribution may be closer to equal.

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