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Trichotillomania

Trichotillomania (TTM) belongs to a group of obsessive-compulsive disorders that manifests itself by the habitual pulling out of one’s hair, which in turn leads to noticeable hair loss. The act of pulling out hair is accompanied by a state of tension, which is followed by a sense of satisfaction and relief. Trichotillomania most often occurs in children aged from 9 to 13, and more than ¾ of the patients are girls. In adults, trichotillomania may be present in otherwise healthy individuals, but it may accompany severe mental disorders. Patients may be unaware that they pull out hair. Sometimes, trichotillomania is accompanied by trichophagia (the eating of pulled hair).

Symptoms
Typically, in the clinical picture, the presence of patches with hair of different length, or hairless patches, is observed. Most often, the afflicted area is a vertex region, although trichotillomania may also affect eyebrows, lashes, facial hair, hair on limbs, and armpit or pubic hair.

Course of disease
Trichotillomania may have a long-lasting course as patients are sometimes unaware of their acts, or may not seek treatment.

Diagnosis
The diagnosis is based on the clinical picture and data from anamnesis (habitual playing with hair in children, often while falling asleep or in stressful situations, presence of a large amount of hair on the pillow). The trichoscopy is sometimes decisive as this disorder presents a very specific image of hair.

Treatment
Treatment consists in the eradication of the habitual pulling out of hair. In many patients, psychological assistance is necessary.