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Submitted by PatientsEngage on 14 June 2017

Shreya Sharma is a regular 20 something Delhiite with the usual quota of friends, foes and social life. When one day she hits upon a strange term on Google that seems to apply to her, she sits up to analyse her own behaviour and triggers for the behaviour. 

Being a law student, I am used to appearing for exams all the time, which is probably why I am rather fed up of studying, even when I find the subjects interesting. So I tend to procrastinate till the very last moment and I’m usually up the whole night planning to study. One particular night, I was as usual up the whole night with the intention of studying from 12-6am, when suddenly my alarm rang, instructing me to go to sleep. I was shocked that it was already 6am. I wasn't surprised because another night had passed without me studying at all, but I was surprised because I realised what I had been doing for the past 4-5 hours. No, I wasn't checking Facebook or WhatsApp, neither was I listening to music or watching videos on YouTube. What surprised me was that, using the light of my study lamp, I had been plucking hair, one by one, from my legs the whole night. Sometimes we might just pull out one or two small pieces of hair our grooming/waxing lady forgot to remove, but imagine doing it for 4-5 long hours straight. Was this just procrastination? Or something else? And as we are all wont to these days, I turned to Google for answers. I randomly typed 'is it normal to pull out hair from different parts of the body?', when Google presented me with this very intriguing term:Trichotillomania.

What is Trichotillomania?

Trichotillomania is a hair pulling disorder, usually in those people who suffer from or have possibly suffered from anxiety or obsessive compulsive disorder. It involves pulling out hair from various parts of the body like the scalp, eyebrows, eyelashes, face, arms, legs etc. I was suddenly reminded of a faint childhood memory. When I was about 3 or 4 years old, I used to enjoy plucking my eyelashes. Reading the signs, symptoms and causes of trichotillomania, I connected the dots and finally realised that I do suffer from this hair pulling disorder. If anxiety is indeed a trigger, then I have also had my share of panic attacks before exams or other competitions.

Trichotillomania (TTM) is characterised by chronic, repetitive pulling of bodily hair. The sites of hair pulling include the scalp, eyelashes, eyebrows, axillary, body, and pubic area. Hair pulling tends to occur in episodes, exacerbated by stress, or sometimes by relaxation (when reading a book or watching television, for example). People with TTM experience an increasing sense of tension immediately before pulling out a hair or when attempting to resist hair-pulling. When the hair is pulled, they experience immediate feelings of pleasure, gratification, and relief.

(Source: http://www.ocdhope.com/trichotillomania-hair-pulling/)

Interestingly, I don’t indulge in this hair-pulling exercise on a regular basis. I don't sit down to pull out hair from different parts of my body everyday. In fact, I do it very rarely and have gone without doing it for years. The areas that get selected vary from person to person. For me, my preferred areas, I realise, are my eyelashes and my legs, which is probably why I have scars all over my legs. Without ever realising that this could actually be a problem, I have at intervals been plucking hair from my legs all my life, whenever I have had the urge to do so. As far as I can recall, pulling out hair from my eye lashes stopped when I was a kid and pulling out hair from my legs probably started after I started waxing my legs, which would probably be when I was 14 years old. I never realised how often I did it or how much time I spent plucking hair out of my legs, but the proof of it being a problem is that I have scars and marks almost all over my legs which, now I realise aren't because of injuries or mosquito bites, but have actually been caused by myself. Also as far as I remember, this interval of pulling out hair has lasted for maybe 2 mins or 2-3 hours in the past ten years and the frequency being, sometimes once or twice a month and sometimes once or twice in 6 months.

The internet further revealed that stress is the main trigger for Trichotillomania. I am not sure whether that applies to me, as I have been engaged in pulling out hair when completely idle. Or perhaps there was some underlying stress leading me to it and I never realised it. A quick self-analysis would go this way:the night I realised I suffered from Trichotillomania, I felt I was procrastinating. I was probably done surfing the internet and instead of studying, I found the activity of pulling out hair a more attractive option. Or maybe I was actually nervous about my exam and was getting even more stressed observing that I'm in no mood to study, thus escaping to my world of pulling out hair. I don’t have an answer to this as I have not consulted any doctor. But now that I know that I have a problem, I distract myself whenever I get the urge to pull my hair.

Extension of the problem

I am also glad that my problem is not very serious. I remember watching an episode of my favourite TV shows Grey's Anatomy in which a patient was diagnosed with a problem of pulling out hair and eating it. This created a huge ball of hair in her stomach, which was discovered only when her stomach was operated upon due to swelling. I found it rather funny watching it 2-3 years back, thinking it's absolutely absurd how people can come up with such stuff. But today that I know of trichotillomania, I realise that the girl in the show was suffering from a much more grave disease called trichophagia, which is an extended version of trichotillomania in which the person ingests hair after plucking it out. The causes and symptoms in both cases are usually the same  i.e. stress, anxiety or OCD. Even though a very small proportion of people suffer from Trichotillomania (statistics say only about 2 to 3 per cent of the population suffer from it), spreading awareness about any issue helps. A lot of people in varying degrees may be indulging in this without even realising that it is a problem.In my opinion, knowing about the problem is 50% solution to the problem itself. If not that, let's just all learn a new word today.

PatientsEngage comment: We would recommend that people see a doctor or a counsellor to confirm a diagnosis rather than just relying on an internet search.