Trichotillomania - is the hair loss permanent?

Trichotillomania

Trichotillomania refers to hair loss caused by a person pulling his or her own hair. Trichotillomania is common and up to 4 % of the world is affected. Some individuals pull hair when stressed. Others have underlying depression, anxiety or obsessive compulsive disorders. Both children and adults can be affected.

Does hair grow back in trichotillomania?

Trichotillomania: This patient's hair loss is caused the self induced pulling of hair. 

Some amount of hair loss may be permanent in trichotillomania, especially if it has been going on for many years. The only way to promote hair growth is to stop the pulling. Repeated pulling damages hair follicles, causes inflammation in the skin and triggers scar tissue to develop.

The photo on the right shows a patient with advanced trichotillomania. Small broken off hairs are seen all over and whitish discolouration from the presence of scar tissue is present. Hair loss in this area is likely to be permanent. 

Treatments for Trichtotillomania

The main treatment is to stop the pulling.  Assistance from a psychologist or psychiatrist is often needed to address the underlying issues that caused the pulling in the first place. Cognitive behaviour therapy, and other types of counselling are the mainstay of treatment. Treatments to promote hair growth (such as minoxidil) and treatments to stop inflammation are often used but these are less important than addressing the underlying psychological issues that led to the pulling in the first place.