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TrichotillomaniaAka: Tonsure Trichotillomania
- Epidemiology
- Prevalence may be as high as 1%
- Most common cause of childhood Alopecia
- Younger ages affected more commonly
- Mean age of onset: 8 years (boys), 12 years (girls)
- Rarely occurs after age 40 years
- More common in females by ratio of 2.5 to 1
- Symptoms
- Patient has irresistible desire to pull out their hair
- Hair pulling episodes
- Hair twisted around finger and pulled
- Duration of minutes to hours
- Satisfaction on pulling out an entire hair with root
- May be associated with eating hair (Trichophagia)
- Sites of hair pulling
- Eyebrows and eyelashes (most common)
- Scalp (especially frontoparietal area)
- Signs: Alopecia
- Coin-sized areas of Hair Loss
- Tonsure Trichotillomania (severe)
- Completely bald except for narrow outer fringe
- Labs: Scalp biopsy
- Hair Follicle shows no inflammatory signs
- Trichomalacia pathognomonic for trichotillomania
- Differential Diagnosis
- See Alopecia
- Alopecia Areata
- Associated Conditions
- Obsessive Compulsive Disorder (most common)
- Major Depression
- Anxiety Disorder
- Eating Disorder
- Management
- Behavior Modification (e.g. habit reversal)
- Hypnosis
- Psychotherapy
- Stress Management
- Medications
- Selective Serotonin Reuptake Inhibitor (SSRI)
- Clomipramine (Anafranil) - sedating
- References
- Habif (1996) Clinical Dermatology, Mosby, p. 755
- Tasman (1997) Psychiatry, Saunders, p. 1271-8
- Koo (2001) Am Fam Physician 64(11):1873
- Messinger (1999) Pediatr Rev 20(7):249
Trichotillomania (C0040953)
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|---|
| Definition (MSH) | Compulsion to pull out one's hair. |
| Concepts | Mental or Behavioral Dysfunction (T048)
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| ICD9 | 307.9, 312.39 |
| English | Hair plucking, Trichologia, Trichotillomania, Trichotillomanias |
| Spanish | arrancamiento del cabello, tricologÃa, tricologia, tricotilomanÃa, tricotilomania |
| Credits | Derived from the NIH UMLS (Unified Medical Language System)
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