A-Z Teen Health Glossary

What is Teen Trichotillomania?


Teen Trichotillomania is an Impulse Control Disorder characterized by teens repeatedly pulling and/or twisting hair until it breaks off.  Impulse Control Disorders are a form of mental illness in which teens are unable to resist a reoccurring urge to act in a way that’s harmful or dangerous. In the specific case of Trichotillomania, teens are unable to stop this behavior of hair pulling, regardless of pain, and even as hair becomes thinner as a result. Females are four times more likely to be affected than males, and sometimes, they might pull hair from other body parts as well, such as eyebrows or eyelashes.


Teen Trichotillomania Treatment | Teenage Anxiety Rehab | Paradigm Malibu


What Trichotillomania Looks Like

Teens with Trichotillomania have an uneven hair appearance, characterized by round patches or patches across the scalp.  Beyond this, there are a number of symptoms of the disorder, including but not limited to teens:


  • Constantly pulling, tugging, and/or twisting hair
  • Denying they pull hair
  • Experiencing increasing stress before pulling hair
  • Experiencing relief after pulling hair
  • Uneven hair regrowth
  • Experiencing intestinal problems, because of eating the hair
  • Exhibiting other self-injury behaviors
  • Skin Problems
  • Permanent hair loss


It’s common for teens with Trichotillomania to also have a Co-Occurring Disorder, or symptoms of:


  • Anxiety
  • Depression
  • Self-Image Problems


Though the direct causes for Trichotillomania are unknown, it seems to have a combination of behavioral and biological factors, including things like stress coping mechanisms as well as imbalanced neurotransmitters.  It’s also commonly associated with incessant feelings of Anxiety, Depression, and/or stress.  Though it’s currently called an impulse control disorder, there’s still some discrepancy on how it should be classified, since it often resembles an addiction or obsessive compulsive disorder.




Residential Teen Trichotillomania Treatment

At Paradigm, we always seek to treat the underlying issues in conjunction with outward behaviors and physical symptoms. Because the specific cause of Trichotillomania is unknown, but is often seen as a Co-Occurring Disorder, we pay special attention to such symptoms in both our initial psychiatric evaluation as well as our teen trichotillomania treatment planning and all sessions.


We use a combination of teen trichotillomania treatment approaches, including Talk Therapy, behavioral therapy, and sometimes, medication. Within talk therapy sessions, our therapists help teens to evaluate and address what sorts of triggers and/or stressors teens experience leading up to pulling hair.  By doing so, therapists try to help teens begin making connections between their feelings and their behaviors, while providing a safe, objective point of view that can help teens to notice and observe their behavior, rather than feeling controlled by it.  Therapists also work with teens to develop other habits and/or alternative resources to help them cope with stress, with the aim of teens being able to replace the hair pulling with a healthy behavior.  Depending on teens’ different interests, therapists might also help them to begin incorporating other positive activities that can alleviate stress, build confidence, and also “distract them” from their desire to pull hair.  Therapists simultaneously work with teens on their belief systems and help them to evaluate any possible false beliefs that are directly or indirectly related with their urge to pull hair.  In this way, we seek to support teens not to only stop pulling their hair, but also to begin feeling relief from stress and anxiety, gaining confidence in themselves, and feeling empowered in their own lives.


Complete recovery from Trichotillomania is very possible for teens.  It’s recommended that teen trichotillomania treatment be started as early on as possible, which helps make the treatment and recovery both quicker and easier.




Does my teen actually need treatment to stop pulling out her hair?

Even though it could seem like your teen is choosing to pull out her hair, in reality, the urge is stronger than her ability to resist it.  Therefore, it isn’t just a matter of her choosing to stop the behavior.  Furthermore, it’s important to understand that she might be experiencing fairly severe symptoms of stress, Anxiety, and/or Depression that are commonly related with this disorder and therefore, it’s important to treat those symptoms as well.

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