Dermnet Videos
Alopecia Videos
- Alopecia areata – Causes and Associated Conditions
- Alopecia Areata Information
- Alopecia Areata Treatment
- Course of Sudden Hair Loss Telogen Effluvium
- Evaluation and Treatment of Sudden Hairloss Telogen Effluvium
- Female Pattern Baldness and Hair Loss Causes
- Female Pattern Baldness and Hair Loss in Women
- Female Pattern Hair Loss Evaluation and Testing
- Female Pattern Hair Loss Treatment
- Hair loss and Alopecia Introduction
- Hair Loss Due To Hair Pulling – Trichotillomania
- Hair Loss Treatment and Male Pattern Baldness Medicine
- Loose Anagen Hair Syndrome
- Male Patern Baldness Causes and Hair Loss
- Male Pattern Baldness and Hair Loss Information
- Sudden Hair Loss Telogen Effluvium
- Traction Alopecia Hair Loss
- Traction Alopecia Hair Loss Treatment
- Central Centrifugal Cicatricial Alopecia
- Discoid Lupus Erythematosus – Clinical
- Discoid Lupus Erythematosus – Histology
- Discoid Lupus Erythematosus – Treatment
- Follicular Degeneration Syndrome
- Folliculitis Decalvans – Clinical
- Folliculitis Decalvans Treatment
- Hair Loss Alopecia With Scarring Information
- Lichen Planopilaris
- Lichen Planopilaris – Clinical Features
- Lichen Planopilaris Treatment
Video Topics
Hair Loss Due To Hair Pulling – Trichotillomania
The scalp is most commonly affected, however patients may also pull out eyebrows, eyelashes, pubic hairs and body hairs. The pulling results in areas of hair loss that contain broken-off hairs of varying lengths. Patients with trichotillomania often deny any type of hair manipulation. Parents of adolescents with the condition often participate in the denial. For this reason, I usually perform a scalp biopsy in patients suspected of having trichotillomania. It is helpful for patients and parents to have an objective test result confirming the more subjective clinical impression of trichotillomania. The differential diagnosis of trichotillomania usually includes regrowing alopecia areata. Both conditions result in areas of alopecia that may contain hairs of differing lengths, and both conditions may have stubble-like hairs giving a rough sensation when touched.
Treatment
The major role of the dermatologist for patients with trichotillomania is establishing the diagnosis. Once this is done, the patient (and family) needs to be informed that the hair loss is caused by hair pulling. Some patients seem to be relieved that their hair pulling behavior is but in the open while others continue to deny any hair manipulation. The next step is referral to a psychiatrist or psychologist. For some families, referral to the school therapist is an acceptable first step down the road to acceptance and treatment of the condition. Treatment modalities given by psychologists and psychiatrists include behavior therapy, hypnosis, psychotherapy and pharmacotherapy. Support groups may also be beneficial.