top of page

Home  >> Problems  >>

Hair Pulling (Trichotillomania)

Hair Pulling (Trichotillomania)

Hair pulling, also known as Trichotillomania or Hair Pulling Disorder, involves repeated urges to pull out hair from the scalp, eyebrows, eyelashes, or other areas of the body. For many people, hair pulling becomes a way of coping with stress, anxiety, tension, boredom, overwhelm, or difficult emotions.

 

Some individuals are very aware of the behaviour whilst it is happening, whereas others notice they pull more automatically or absent-mindedly, particularly during periods of stress, concentration, or emotional discomfort.

 

Hair pulling can lead to distress, shame, embarrassment, low self-esteem, and difficulties in social, work, or relationship situations. Many people struggle silently for years before seeking support.

What can hair pulling feel like?

Hair pulling can affect emotions, thoughts, behaviour, and physical wellbeing in different ways.

 

Emotional experiences

  • Anxiety or tension before pulling

  • Temporary relief, comfort, or satisfaction after pulling

  • Shame, embarrassment, or guilt

  • Frustration about difficulty stopping

  • Low confidence or self-esteem

 

Behavioural patterns

  • Repeated pulling from specific areas of the body

  • Searching for certain hairs based on texture or appearance

  • Pulling during stress, boredom, concentration, or relaxation

  • Avoiding situations where hair loss may be noticed

  • Using hats, makeup, false eyelashes, or hairstyles to conceal hair loss

 

Cognitive experiences

  • Feeling unable to resist urges

  • Harsh self-criticism about the behaviour

  • Difficulty understanding triggers

  • Fear of judgement from others

 

Physical effects

  • Noticeable hair loss or thinning

  • Skin irritation or soreness

  • Damage to hair follicles in some cases

 

Some individuals may also engage in related behaviours such as skin picking, nail biting, or other body-focused repetitive behaviours.

What can contribute to hair pulling?

Hair pulling is often linked to emotional regulation and coping. Contributing factors may include:

  • Anxiety or chronic stress

  • Perfectionism or tension

  • Emotional overwhelm

  • Trauma or difficult life experiences

  • Low mood or boredom

  • Sensory regulation needs

  • Neurodevelopmental differences such as ADHD or autism

 

Hair pulling can also become habitual over time, where the behaviour temporarily reduces tension or discomfort and therefore becomes reinforced.

How common is hair pulling?

Hair pulling is more common than many people realise and can affect children, adolescents, and adults. Many individuals feel significant shame about the behaviour and may hide symptoms from others for long periods of time.

 

Hair pulling is recognised as a Body-Focused Repetitive Behaviour (BFRB) and can occur alongside anxiety, OCD-related difficulties, perfectionism, trauma, or emotional regulation difficulties.

What treatment do we offer?

Support focuses on understanding triggers, reducing shame, increasing emotional awareness, and developing healthier coping strategies and behavioural alternatives.

 

Cognitive Behavioural Therapy (CBT)

CBT is one of the most evidence-based approaches for hair pulling and may help by:

  • Identifying emotional and situational triggers

  • Increasing awareness of pulling patterns

  • Challenging self-critical thinking

  • Developing alternative coping strategies

 

Habit Reversal Training (HRT)

Habit Reversal Training is a structured behavioural approach that may involve:

  • Increasing awareness of urges and behaviours

  • Identifying triggers and high-risk situations

  • Developing competing responses or alternative behaviours

  • Reducing automatic pulling patterns

 

Compassion-Focused Therapy (CFT)

CFT can support:

  • Reducing shame and self-criticism

  • Building emotional safety and self-compassion

  • Understanding the behaviour as a coping response rather than a personal failure

 

Emotional regulation support

Therapy may also help individuals to:

  • Manage stress and anxiety more effectively

  • Develop healthier coping strategies

  • Increase emotional awareness

  • Reduce overwhelm and tension

A compassionate note

Many people living with hair pulling feel ashamed, frustrated, or alone, particularly if they have tried repeatedly to stop without success. Hair pulling is not simply a “bad habit” or lack of willpower. It is often a coping response linked to emotional regulation, stress, or nervous system relief.

 

With understanding, compassionate support, and evidence-based strategies, many people are able to reduce hair pulling behaviours, manage urges more effectively, and develop a kinder and more supportive relationship with themselves.

Further support and resources

You may find these trusted organisations and resources helpful:

bottom of page