Information on the common hair pulling disorders - trichotillomania and traction alopecia



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Home >> Hair shaft abnormalities >> Trichotillomania and Traction Alopecia

Common hair pulling disorders
In terms of the mechanical action that causes hair loss, traction alopecia and trichotillomania are exactly the same. In both of these hair pulling disorders the hair is plucked out of the skin which leaves clear bald patches or diffuse, thin hair.

In traction alopecia the cause may involve things like tight hat bands or tight braids. If bands are used to tie tight pony tails, or cornrow hair styles are used then the roots of the hair are pulled on (traction). And when the traction continues for a long time and the same hair is repeatedly stressed, then the hair sheds off and the follicles in the skin can become damaged. The hair may eventually stop growing leading to permanent scarring alopecia.

Trichotillomania
Trichotillomania is characterized by the repeated urge to pull out hair fibers mainly from the scalp, though the focus can also be on pulling eyebrows, eyelashes, beard, nose, pubic or other body hair. It is a condition in which the affected individual plucks or pulls out their own hair. Often, the pulling of scalp hair leads to bald patches.

Once a bald area has been made it becomes even more enticing for an individual to pull the hair around it and make the alopecia patch larger. Sometimes the effect of hair pulling is more generalized and looks like diffuse alopecia. Diffuse alopecia tends to affect the whole scalp, rather than specific areas of it.

Trichotillomania is generally a non-scarring, non-inflammatory form of hair loss. But long term repeated plucking over several years may result in scarring alopecia to some hair follicles. Scarring Alopecia manifests itself with the onset of rough patches on the surface of the scalp.

Cause of trichotillomania
The general cause of Trichotillomania may be anxiety disorders or mood problems. The hair pulling disorder is considered as a neurobiological condition This form of hair pulling disorder is not only seen in humans, but also in many other species like mice and cockatoos. Mice under stress will pull out each others hair while unhappy cockatoos may pluck out their own feathers.

Effects of the hair pulling disorder
In this disorder the affected individual is most often unaware of their impulsive habit. In some cases individuals who pluck their hair also eat it which is a condition called “trichophagia”. This is a very dangerous condition that needs to be treated with some urgency. As the hair is not digestable in the stomach, it can build up into a hair ball. This hair ball can severely irritate the stomach leading to ulceration. In some cases the formation of hair ball in the stomach can be life-threatening too.

Treatment
Treatment of trichotillomania is quite difficult and complex. There are 2 approaches for treating trichotillomania. One approach is to visit the psychiatrists and the other is to the dermatologists.

Psychiatrists will naturally focus on the psychology of the patient. He/she will try to find out why the patient might have developed the habit of hair pulling. The psychiatrist may try a therapy treatment to cure the hair pulling disorder particularly when the patient is a child. While in adults they may suggest suitable drugs.

Dermatologists take a more direct approach while treating this hair pulling disorder. Children with trichotillomania may be made to wear gloves. The gloves stop the sensation of touch and this makes it impossible for the child to identify suitable hair for plucking. Sometimes the affected child's hair may be covered with vaseline which makes it difficult to get hold of the hair and also the hair becomes unpleasant to touch. In extreme cases the scalp may be bandaged so that the child can't touch the bald area.

Traction Alopecia
Unlike trichotillomania, traction alopecia treatment is simple if treated in the early ages. An effective treatment is to simply avoid hair styling that puts excessive strain on the hair roots. Even after avoiding the causes of the traction alopecia it may take a period of several months for the hair to recover from this severe hair pulling disorder. Areas of scalp subjected to chronic traction alopecia may never fully recover. Chronic traction alopecia may be sometimes treated by hair transplants.

If the treatments of these severe hair pulling disorders are taken up at an early stage, there is enough probability that the hair will regrow in these areas. The only factor that should be carefully maintained is a strict hair care regimen. So even if you are suffering from these severe hair pulling disorders remain disciplined in your hair care regimen and have patience to watch your hair growing vigorously.

References:
Monk BE, Neill SM, du Vivier A. “Fashion causes traction alopecia. Practitioner”, May 1986; 230(1415):401-2.


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