Everything You Need to Know About Trichotillomania Symptoms

Trichotillomania, or trich, is repeated hair pulling that leads to hair loss, where you keep trying to cut back and can't. For the overview and causes, see what trichotillomania is.

The urge to pull

The core symptom is the urge. It can feel like tension building in your scalp, your fingers, or your whole body, and pulling brings a moment of relief or satisfaction. Then the relief fades, and you might feel frustrated or embarrassed afterward.

Not all pulling starts with a strong urge, though. There are two common patterns, and you might do some of both:

• Focused pulling: you know you're doing it. A hair feels coarse, kinked, or out of place, and you need it gone.
• Automatic pulling: you don't notice until after, like while you read, drive, study, or scroll.

Physical signs of trichotillomania

• Thin spots or bald patches on the scalp
• Missing or patchy eyebrows or eyelashes
• Hairs broken off at different lengths in one area
• Hair that feels coarse or grows back differently
• A sore, itchy, or irritated scalp where you pull
• Pulling from the beard, arms, legs, or other body hair

Hair loss from trich can be easy to hide, especially early on. A doctor or dermatologist can look at your scalp and help rule out other causes of hair loss.

What happens after pulling

Some people with trich have things they do with the hair after it's out. You might:

• Look closely at the root
• Roll the hair between your fingers
• Run it across your lips or face
• Bite or chew the root or the hair
• Save it, or line the hairs up

If you swallow hair, tell a doctor, since it can build up in the stomach. None of this is strange. It's a common part of trich, and it's worth mentioning to a therapist because it helps them see your full pattern.

Anxiety and stress

Stress and anxiety can make pulling louder, and pulling can take the edge off for a moment. But pulling also happens when you're calm and bored. So stress is one trigger, not the whole story.

That's also why "relax" doesn't fix it. You don't have to get calm before you can stop pulling. You can let the urge and the stress be there and still keep your hands busy until the urge fades.

I know, someone has probably told you to stop touching your hair. If that worked, you'd have stopped years ago.

Changes in mood

Living with trich can wear on you. Common feelings include:

• Shame or embarrassment about pulling or about how your hair looks
• Frustration at yourself for not being able to stop
• Worry about someone noticing
• Low mood, especially after a bad pulling stretch

Trich can mean skipping haircuts, swimming, windy days, or close contact. If low mood sticks around or gets heavy, talk with a doctor or therapist. Trich often shows up alongside anxiety or depression, and both are treatable too.

Common questions about trich symptoms