Trichotillomania

Trichotillomania. I can’t spell the words “schedule“, “definitely” or “regularly” without the help of spellcheck, but I can spell “trichotillomania“. It’s a good thing, because wordpress’s spellcheck doesn’t recognize trichotillomania as a word.

Trichotillomania (compulsive hair pulling) is the one diagnosis I have that all mental health professionals I’ve met with are in agreement about. I, however, feel very out of place in internet communities for those who share my diagnosis. I don’t pull from my scalp, so my problem is more easily hidden. As a result, I don’t suffer from the social consequences that many people have to deal with.

My favorite hairs to pull are ingrown ones. They don’t belong. They’re already defective, they are guilt free pulling.

First I notice the irritation of the skin. Sometimes I can see the hair sometimes I can’t. When the area is more inflamed I poke it with a pin to release the fluid. Digging with tweezers, pins and fingernails I search for the hidden hair. Sometimes blood obstructs my work. I have to allow a day of rest before resuming.

I question the existence of the hair. Maybe I already pulled this one out and forgot? Maybe the skin was irritated from something other than a hair? Was that a shadow or a hair?

After some healing, I recommence my hair retrieval mission. When finally I free the hair from my , then mutilated, skin, I feel immense satisfaction. The greater the length of the hair the greater the satisfaction. The visual is very important to me. I study it wondering how long it had been hiding in my body. Sometimes dead skin is firmly attached to the strand. I slide it off carefully, examine both hair and skin individually and dispose of them.

I replay the scene over and over in my head, eagerly awaiting my next opportunity to repeat it.

Nose hairs are my second most favorite type of hair to pull. They are also the most uncomfortable to discuss. There’s such social stigma about putting fingers up a nose, pulling out a hair there is even worse. I can comfortably tell therapists I pull pubic hair, but often omit the nose hair.

Using tweezers makes me sneeze, so fingers are the way to go. I wonder about the risks of pulling a hair with such an obvious purpose (filtration of the air). I justify it by pointing out to myself, ‘I can’t reach all of them to pull. The ones farther up are still in place functioning.’ I don’t seem to get sick more than average so I suppose it’s fine.

Eyebrows and eyelashes are the source of the most post-pulling-guilt. I start with light tugs. The hairs coming out in my hands are ones that were about to fall out anyway, right? If I’m not careful this quickly escalates into harder tugs. Now it’s uneven. I have to keep pulling to even things out, right? I have to finish the job. It’s all or nothing. Fortunately, I’ve had this more under control in recent years. I started wearing makeup more often. Mascara makes it easier to accidentally pull more hairs in one tug, but seeing the mascara on my hands helps to remind me to stop. Seeing eyeshadow on my hands when pulling eyebrows helps the same way. Wouldn’t want smudgy makeup, would I?

I also pull arm, leg and underarm hair. These are the socially accepted places for hair removal, but I take it to an extreme. Shaving feels like cheating. The hair is still there. I want it gone. I am in a constant struggle to remove it all. There is always that one hair I missed. I remove that and then there’s another.

I use an epilator (basically electronic tweezers) to remove it. I advocate epilators as aggressively as some women advocate diva cups (diva cups freak me out by the way. I bought one and it sits in my desk unused). Epilating is a very soothing experience for me. Unfortunately is as a noisy device. I try to minimize the time I use it when others are home. I don’t want people realizing how much time I spend removing hair.

At times when I don’t have access to an epilator I will eventually begin pulling out the hairs individually. I can tolerate a certain amount of hair, but I have a limit. That limit is lower when stressed. At my first hospitalization I reach that limit. The staff didn’t understand my situation and wouldn’t let me use my epilator because it had a cord (no wires allowed. I could strangle myself -_-). They also misunderstood my trichotillomania as a type of self-injury. I was individually pulling out my hairs, gripping them with my finger nails. I reached the point where I was wiling to compromise with shaving. I couldn’t have a razor to shave either, because I cut. My roommate, who was allowed to shave, took pity on me and allowed me to use her razor on the condition that she supervised to see I didn’t cut. It was very much appreciated. I was eventually allowed access to the epilator under supervision from staff.

Let me elaborate on that point I just made. Trichotillomania is not self-injury. Some people might pull their hair as self-injury, but that is not trichotillomania.

When I self-injure I want to see destruction. When I pull I aim for perfection.

I self-injure as a direct response to stress. I know I will release that stress by self-injuring.

I often start pulling without even noticing. While stress may play a role, it is not the entire explanation. I pull at times I am bored or have inactive hands as well as in reaction to stress.

What they do have in common for me is the importance of visuals. I have to see the hair I pull out, just like I need to see the damage from my self-injury.

I tend to pull more with my right hand than left, which is interesting as it is my non-dominant hand. Pulling with my left hand feels strange.

I have some ideas regarding environmental root * causes for my hair pulling, but I’ll save that for another post.

*ahah poor word choice

23 thoughts on “Trichotillomania

  1. that’s very interesting. I also get great satisfaction from releasing an ingrown hair and do the whole “looking at it for a long time” then spend ages going over the rest of my body to see if I can find another one. Purely for the satisfaction of getting it out… strange creatures aren’t we?

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  2. Hello,
    just came across your blog and this post leapt out at me. If you compare my addy (not published) with a prior comment I left you will know who I am.

    Basically snap.
    I hate it that I pull my hair. It is a strong compulsion that I am really struggling with. I dont do scalp hair either.

    I would be interested in hearing what you think are the “root” !!! causes.

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  3. Ah, so refreshing! I have almost the exact same display of TTM, same pulling places, ingrown hairs, etc. My epilator is my saving grace! Without it I can lose hours at a time with a set of tweezers and my legs. It doesn’t stop it, but the stress caused by the amount of hair that could potentially grow at any time is greatly reduced. I am also a cutter and you’re right, they have completely different goals.

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  4. a bit easier since I am not alone in this..so much time invested and the result? never satisfying..I found that hair removal with sugar paste is the way to go – it leaves skin smooth and not irritated and the hairs grow back very slowly and much thinner

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  5. I have been suffering with TTM for a number of years now and it seems to have gotten worse more recently, most likely due to increased stress from work and the growing family at home. I have an issue with ingrown facial hairs and I am always on the hunt to try and remove the next possible “offender”. Finding an ingrown hair, I’ll use a pin and tweezers as well and this usually results in an unsightly irritated patch of skin. I also spend too much time with the tweezers but end of mutilating my skin if I don’t have them at hand. I think some people mistakenly think I have meth sores or something.

    The satisfaction of pulling, viewing the hair and the bonus dead skin, if it has one, is mesmerizing. I feel so ashamed when I’m caught in my office pulling by coworkers…ahhh the constant battle.

    It is comforting to know that so many others are afflicted with the same.

    Reply
  6. “Trichotillomania is not self-injury.”

    Thank you, thank you for saying this. I am going to my counselor in a few minutes & had a really bad trich episode yesterday so was looking for some more info both for myself and for her. But what I really got from reading that sentence was a small release of guilt and realizing that maybe this isnt all my fault that I cant just stop it.

    “When I self-injure I want to see destruction. When I pull I aim for perfection.”

    This is SO absolutely true for me too. I dont cut anymore but I did for several years and it was injury I wanted/needed to see on my skin. When I pull, or rather more recently use scissors or razors, just like yesterday I was aiming for perfection. What I got instead was something very different than what I had aimed for or ever expected. Thought I was being careful but now Im embarrassed and feeling stupid. Like I knew better than to do too much but I had to fix it so did it anyway.

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  7. I have a tweezing/shaving obsession, no pulling with my fingers or anything. Does that mean I have trichotillomania?

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  8. “When I self-injure I want to see destruction. When I pull I aim for perfection.

    I self-injure as a direct response to stress. I know I will release that stress by self-injuring.

    I often start pulling without even noticing. While stress may play a role, it is not the entire explanation. I pull at times I am bored or have inactive hands as well as in reaction to stress.”

    I self-injure as a direct response to stress. I know I will release that stress by self-injuring. I still considered this a part of my TTM though. Pulling was a great catharsis…that just always circumvented back to profound shame and guilt. The third point you make draws a great attention to the notion of conscious/unconscious and/or awareness of while pulling, which makes the DSM 5 qualification of “self-injury” THAT much more tricky (very poor word choice, eh?)

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  9. Thank you! that was really well written and I can understand why I love plucking out those infected ingrown hairs to the point where people ask my what happened to my arm and my family ask what happened to my chest.

    I’m also very interested to read what you think the root causes could be. Please take the time to think about it and type it up, if it only helps one person it’s worth all your time and energy to do it.

    Reply
  10. I pull for perfection… It started at 27.. But I had jumped from vice to vice since early child hood.. I do believe its from shame and guilt. I am so aware of others I study them. I have been able to spot a few other ppl coworker and even friends in the last 7 years suffering just like me but I never would dare to reach out and share ever. This is the first time I am ever telling anyone. It’s embarrassing. I was never aware or cared about hair before I shaved and waxed normally. Then one day I notice hair on the nape of my neck and it grossed me out. I have been hooked ever since. I want it out… gone…. It I have more tweezers then any human should. I ever sharpen them.. I lock myself away in my house alone and pull with fingers on my face and body for sometime 12 hours. I fight the urges because once I pull out the first hair I cant stop. I isolate myself and the ritual begins. If I have to get ready for work sometimes im late or call out or I just try to multi task pulling and getting ready at the same time. Thats taken years to pull off.. And its far less gratifying. It starts if im dehydrated and/if im stress even tired. I have a love for my lashes brows and on my hair on my head. I never touch them they are perfection to me. Everywhere else pubic hair make me feel the best upon removal. Hour and hour pulling and thinking about how gross I am and why do I have hair. Or I am in a trace day dreaming or im ‘working’ searching for the right texture hair to pull looking at each and every one of them alternating between finger the tweezers. It’s a never ending job. I have tweezer in my bed couch etc randomly all over my house. I get into such a trance leaving them places. i try not to break the skin
    Any more but I will and have to reach the hair that needs to be removed. I use various products to clean the tweezer and my hands and skin like peroxide and alcohol and rolls of papertowls to put the hair I pull out. This has and is ruining my life. I cant stand being this way and I hate being aware of hair… I miss how I was before.. To look at me you would never think I am the person who-posted this random grammatically incorrect miss spelled blog lol… I am told how beautiful I am every day. I obvi know im attractive to some extend however I must have low self worth and not think im pretty enough or good enough. I have intimacy problems because of this. I settle for men who are not available and who are selfish that way I have space and eventually can have a sexual connection they are less likely to want to please me and caress my body i pull and feel shame and disgusted about, All the while i long a man to meet my emotional needs but cant ever allow myself. being in with-the selfish man is a torture I feel comfort in… If anyone has any thoughts or information they can share with me from a phycological aspect and helpful info to over come this please share. I want a normal life again

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  11. Sullen Girl,
    Thanks for sharing your story. Sorry, no idea from a psychological aspect but I just wanted to add my support. As I type this the need to pull out my eyebrow hair is intense. The thick stubbly hairs. I have been trying to regrow my eyebrows for 3 years now. Unsuccessfully. Good luck. I wonder if the intimacy issues are a common thread. I have these issues. xx.

    Reply
  12. me said
    thanks for your support. I am here too. Feels great to finally share. I stumbled upon this web site by accident. I thank god i did. Perhaps you could try tattooing them. I hear its reasonable and looks very nice. Thats one area of hair I have total discipline not to pull and never go there. Perhaps because Its on my face out in the open and hard to conceal. I dont understand how this condition begins. It began in my late 20’s. I lived without doing it for 27 years. Now even as I sit here typing im aware if every single hair on my body screaming for me to pull them out.

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  13. I recently came across your blog and just wanted to say how much I can relate! I too have trich and pull from my eyebrows, underarms and other places with thick hair, not my head. The way I feel about the hairs in my armpits is almost as though they’re foreign bodies that have to be got rid of and I will go to great lengths to dig out ingrown hairs. The longest I’ve managed to stop for is six months, but I’m currently allowing myself to pull as other issues I’m dealing with seem more pressing to address.

    I also relate a lot to your posts about therapists, how there’s an underlying pattern of an avoidant attachment style but how there were always also other good reasons for leaving at the time. That’s been the case for me too (I think I’m up to at least #15, not counting one-off assessments, and I’ve had lots of different types of therapy). I love your graphic of what makes therapy worth it – it’s spot on!

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  14. I also pull pubic hair, and you just described every step of my process perfectly. I too pull for perfection. It’s interesting to see that others struggle with such similar things. Every word you used to describe your experiences rang true for me. It’s so surreal. I wish I’d seen this sooner, I could have been diagnosed more quickly if I’d known.

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  15. I am 38 yrs old. My TTM experiences began about 8 yrs ago during my first marriage. As stress, anxiety & unhappiness in my marriage progressed, I began plucking leg hairs obsessively at night while my then husband & children slept. I too would dig out ingrown hairs to the point of leaving extensive sores all over my legs. I am extremely fair skinned, so it was not easily hidden & my ex husband demanded I tell him what happened. It went on for a couple yrs, until my family kept catching me doing it & would comment about the sores & how horrible my legs looked as a result. They would take away all of my tweezers; I would buy more, they would take them whenever I left them out, or if they found my hiding places. I began using my finger nails cause my nails have always grown long easily & I have never been a nail biter. Once my ex husband & teenage niece that lived with us caught on to that…they demanded I keep my nails cut short always. I complied only because they made me feel shameful about it. My ex husband belittled me about it, because I would spend so much time plucking & pulling leg hairs that I didn’t keep up on housework. I also worked outside the home & would often experience insomnia, which would heighten my TTM. I finally stopped doing it back then. In early 2010, my ex husband & I separated & began divorce proceedings. It was & continues to be an extremely contentious relationship. We have 3 children & met when we were 13, began dating at 16, married at 20, had our oldest daughter at 21, & our twins at 25. We split up at 34. I remarried in Jan 2013. I now have a step daughter. My husband & I have primary custody of all 4 children; though we had to fight hard to get my step daughter. My ex fought me all the way until the court appointee recommended custody go to me. He could’ve requested a custody trial, but opted not to, as it would’ve been costly, & difficult to overcome. Anyway, my husband’s ex wife causes constant problems, along with my ex & his new wife. The 3 became friends when they were trying to fight custody. They wrote letters for each other stating what bad parents we are. They bullied each of us in texts, social media, etc. So in the last few months, my TTM has returned. My new husband is horrified & constantly catches me picking with my finger nails & tells me to knock it off. I currently have about 10 sores on my right leg. A couple on my left. After I got remarried & had medical insurance again, I was diagnosed with anxiety, plus extremely high blood pressure. I quit smoking & have gained a lot of weight. I have had heart disease since I was 11 yrs old. The shame I feel is immense, but I feel satisfied to get those pesky hairs out & despite shaving everyday, I still find those stubbles & dig them out. It is comforting to know others suffer from this. Thank you for letting me share. Hoping to get control of it again…

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  16. I started pulling out my neck hairs only! I use tweezers & am very satisfied when I get one/ingrown & when I uncurl it & its longer than armpit hairs weird as it is I GET SATISFACTION! I thought I was alone & do not do it in public I am ashamed/embarassed of it, even hate to admit it…my only friend of thirty plus years tried to help me by reminding me not to pick he was the only one I let see the truth! HE WOULD SAY QUIT PICKEN NICELY BUT I DID LEARN NOT TO DO IT IN PUBLIC. AT HOME I TWEEZE THE WHOLE TIME I WATH TV ALSO OR AM NOT BUSY! I have no idea why this started but I thought that if I removed them by their roots that they WOULD NOT GROW BACK/WRONG UGH NEVER ENDS

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  17. I have had this same form of trich since I was about 8. I am 24 and I still struggle with problem areas, but my saving grace has been electrolysis. I suggest finding someone who is wonderful to talk to and non judgemental. Trust me everyone, it’s worth it. The satisfaction of zapping the follicles into non existence is even greater than digging out those ingrowns. It takes determination and self discipline to NOT pluck, pull, dig, and scar, but that feeling of perfection will be achieved in due time. I’m getting amazing results and I’ve struggled with this (hair pulling) crap for over a decade, and it’s time that I share my immensely satisfying solution with everyone who shares my problem. Please, heed this: your hair will only get thicker, longer, more ingrown and create more scar tissue if you keep going down this path, until it becomes so overwhelming that even digging and pulling won’t stop the crying and shame.
    Much luck to you all,
    A long time trich sufferer.

    Reply

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