Trichotillomania: Things That Help

Trichotillomania is a compulsion to pull your hair or pick your skin, sometimes with the added complication of eating the pulled hair.

Although the actual health dangers are few, except for those who eat their hair, the behavior is compulsive, socially awkward, and a little contagious-- trich sufferers with dogs are more likely to have dogs who obsessively lick or scratch flea bites and other hot spots.

I have had this compulsion since early adolescence, and I certainly come by it honestly-- my mother is a scalp-picker, too. I probably learned it, but now I can't unlearn it. Because my lifestyle precludes ongoing care for any health or mental issue, I pretty much have to take treatment into my own hands. This Hub is dedicated to the tools and resources I've found that help, sometimes in small ways, sometimes in really big ways. 

Trich can be caused solely by mental issues, but there seems to be a connnection to an allergic reaction to a particular oil produced naturally in the skin. The allergic reaction may not be a typical histimine reaction, but there does appear to be a tie between inflammation from this oil and the practice of pulling or picking. 

Hygiene is one way to combat this skin oil. Now, you don't want to replace compulsive skin-picking with compulsive skin-washing. But you do want to carefully evaluate whether or not a skin product is contributing to your behavior.

Products containing sodium lauryl sulfate (which includes almost all shampoos), alcohols, cetearyl, cetostearyl, and cetyl may contribute to hair pulling or skin picking. Select products that are low in oils and have mild natural astringents, like witch hazel and tea tree oil. 

Because trich can be caused by diet, avoid foods that trigger it. Caffeine, sugar, and oils are the big offenders, of course, but also corn products (including high fructose corn syrup), MSG, Nutrasweet/aspartame, and legumes.

If you're a hair eater, be aware that your own hair contributes to this reaction, so the less you eat, the less you will feel a compunction to do it. 

As a temporary or transition measure, it can help to substitute the picking/pulling behavior with other behaviors. Generally, the behaviors that are good choices are repetitive hand motions that don't cause a detrimental effect on your body (like eating):

• knitting or crochet
• embroidery
• juggling
• typing
• playing a console video game requiring 2 hands 
• playing cat's cradle
• whittling
• playing a guitar
• fingerpainting
• painting your fingernails (though this can lead to cuticle picking or nail biting)
• solving a rubik's cube 

In short, choose an activity that requires both of your hands and which fits well into the times when you are most likely to pick. A common time is when watching TV, so developing a quiet rubik's cube addiction at that time may be very helpful. 

I call it a "blocker" when I do something to physically prevent myself from picking. I wear a hat a lot. In fact, I became known at work as "the hat lady" because I wore very colorful and interesting hats every day. People thought it was a style choice, but really, it was because I didn't want to be known as "the hair picking lady."

• wear a hat 
• get acrylic nails (they're so thick, it's hard to pick or pull)
• wear gloves
• wear glitter in your hair (who wants glitter on their fingers?)
• wrap a scarf or shawl around your head
• wear headphones 

Without a definitive cause, it may be impossible to ever fully cure trichotillomania. However, a number of behavior modification therapies have worked, including alternative therapies like Emotional Freedom (EFT, or tapping), hypnosis, support groups, and supplements like inositol.

What doesn't seem to work very well are pharmaceutical drugs. While drugs can be effective in easing anxiety and treating other disorders, and medications may make a hair puller feel better about pulling, they frequently do little to actually stop the behavior itself.

If you're a hair puller, skin picker, or hair eater, do try to find professional help or a support group to help deal with the problem. Even if all you can deal with right now is handling the social anxiety related to this "bad habit," that's a good place to start. And remember, not every therapist is right for every patient, so don't be afraid to shop around and find someone you can really work with.