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Trichotillomania: What Causes a Person to Pull Out Their Hair?

Have you ever been so frustrated that you felt like “pulling out your hair”? Chances are you threw your hands up in a gesture of frustration but made no attempt to harm your hair. But people with a disorder called trichotillomania compulsively pull out their hair – sometimes to the point of balding their scalp and destroying most of their eyelashes. And this isn’t a rare condition either. Estimates are that up to 3% of people have a hair pulling addiction.

What Causes Trichotillomania and Hair Pulling Addiction?

According to researchers at Duke University, compulsive hair pulling may be in the genes. Specifically, they found that a gene called SLITRK1 is involved in trichotillomania and other disorders where a person has a problem controlling their impulses. When this gene is mutated, it causes abnormal communication between nerve cells, which can trigger the urge to tug at one’s hair.

Hair Pulling Addiction

Not everyone who has trichotillomania has this gene mutation, so environment probably plays a role too. In fact, other emotional problems like anxiety and depression are more common in people who compulsively pull on their hair – and hair pulling may be used as a way to relieve stress.

Most hair pullers describe a sense of relief after tearing out a handful of hair. Some people who have a hair pulling addiction aren’t even aware they’re pulling out hair and may not remember doing it.

Can Compulsive Hair Pulling Be Treated?

Traditionally, doctors have been used behavioral therapy and medications such as anti-depressants to treat trichotillomania with varying degrees of success. Recently attention has turned to a new treatment – an antioxidant called n-acetylcysteine, or NAC.

What is N acetyl cysteine good for?

In a study published in the Archives of General Psychiatry, 56% of people with trichotillomania showed improvement on NAC after only 9 weeks. This was a small study involving only 50 people, but it was randomized and double-blinded, which adds legitimacy to the results.

NAC works by altering levels of an amino acid in the brain called glutamate, which plays a role in impulsive behaviors.

 Even better, n-acetylcysteine is available at most health food stores and is safe when taken in reasonable doses. 

Because it’s an antioxidant, it may have other benefits as well. Some small studies show it slows down aging in mice and reduces fatigue in athletes.

Trichotillomania and Hair Pulling Addiction: The Bottom Line?

Compulsive hair pulling is a surprisingly common disorder that can cause considerable frustration and loss of self-esteem for the unlucky person who has it. Fortunately, a natural antioxidant called NAC could help to treat chronic hair pullers – before they end up bald


ABC News. “Compulsive Hair Puller? Not Your Fault”

Trichotillomania Learning Center. “N-acetylcysteine for Trichotillomania, Skin Picking, and Nail Biting”

Archives of General Psychiatry. July 2009.

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