Trichotillomania (TTM) is an impulse disorder that causes people to pull out the hair from their scalp, eyelashes, eyebrows, or other parts of the body, resulting in noticeable bald patches. It is currently defined as an impulse-control disorder, but there are still questions about how it should be classified. It may seem, at times, to resemble a habit, an addiction, a tic disorder or an obsessive-compulsive disorder. It is estimated to affect one to two percent of the population, or four to eleven million Americans.

Who Gets Trichotillomania?
TTM seems to strike most frequently in the pre- or early adolescent years. The typical first-time hair puller is 12 years old, although TTM has affected people as young as one and as old as seventy. It is thought that ninety percent of those with TTM are women, but research is inconclusive and it may simply be the case that men are less likely to seek treatment and can more easily hide their symptoms. A form of TTM that affects very young children appears to occur in males and females at an equal rate and seems to be more benign in nature.

How Do I Know If I Have Trichotillomania?
Although the symptoms range greatly in severity, location on the body, and response to treatment, most people with TTM pull enough hair over a long enough period of time that they have bald spots on their heads (or missing eyelashes, eyebrows, pubic, or underarm hair), which they go to great lengths to cover with hairstyles, scarves or clothing, or makeup. The persistence of the compulsion can vary considerably: For some people, at some times, it is mild and can be quelled with a bit of extra awareness and concentration. For others, at times, the urge may be so strong that it makes thinking of anything else nearly impossible.

Why Doesn’t Anyone Seem to Know about Trichotillomania?
TTM did not appear in the popular media in the United States until about 1989. As a result, many people with TTM have gone for many years without adequate Information about their condition, or appropriate treatment. Consequently, the one symptom that most people with TTM share is shame.

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