Medical Watch: Spotlight on rare hair pulling disorder

HealthDiseases and IllnessesPharmaceutical IndustryChemical IndustryRush University

 Everyone is familiar with the phrase, “it makes me want to pull my hair out.” But what you might not know is that some people really do feel that way and they pull until they have no more hair left.

It’s not a common problem, but it is common enough that someone you know may have trichotillomania.

When you first see Mary McLaughlin you notice her beautiful smile, her bright eyes, and her head full of long brown hair.  But the hair, is a wig and McLaughlin talks about her struggle with the urge to pull out her hair.

“It's just I've been in and out of hair pieces, weaves, that kind of thing ever since I was 12,” said McLaughlin.

 At 12, McLaughlin was a vibrant, young girl with a habit that spiraled out of control.

“I just did it a couple of times,” she said. “And I didn't know right away that it was going to be a problem, but I knew that I was drawn to it in a way that probably wasn't right, necessarily.”

“Trich[otillomania] is a compulsive pulling of the hair, usually the top of the head, but I've seen a man who pulls from his beard,” said Dr. Ira Harper, a psychiatrist at Rush University Medial Center who has been treating McLaughlin.  “Pulling can be from the arms, from the legs, from other parts of the body.”

 The first bald spot appeared on top of McLaughlin’s head.  Then it got bigger and her parents began to notice.

“I didn't think about anyone who was a foot taller than me being able to see any of that,” McLaughlin said. “[But] my parents had heard of the disorder before and so they were inclined to put me immediately into therapy and start figuring it out from the beginning. But I said, ‘Now that I'm accountable to someone, I think it'll stop.’”

The pulling never stopped but that didn’t stop McLaughlin from being involved in school and sports.

“I played basketball all through junior high and high school and I would do what I had to do to secure [the wig] before a game because I wasn't going to miss out on the things that were important to me,” McLaughlin said.  “So I think you can spend time hiding or you can get out there and live your life.”

 Now as an adult with a high powered job and a more stress in her life, McLaughlin decided to seek help and turned to Dr. Halper.

“I've treated a significant number, I'd say at least two dozen patients with trich[otillomania],” Halper said.

 He uses cognitive behavioral therapy to help the patients learn techniques to counteract the pulling.  Halper also helps patients learn to restructure the thoughts that facilitate pulling.

“I think hair pullers have this tactile sensation that they need to fulfill with their hands,” McLaughlin says as she continually wrings her hands in her lap.  “I'm kind of a fidgety person.  I need to be using my hands.”

Halper combines those skills with medications to reduce some triggers of hair pulling.

McLaughlin takes medication for depression and naltrexone – an anti-addiction medicine often used for alcoholics.

“It’s bigger than a habit,” McLaughin said.  “It’s bigger than your control so you can’t be mad at yourself about it.” 

Halper believed their might be more to McLaughlin’s hair pulling.  He believes the root cause is an infection that plagues children.

“There is now evidence that trichotillomania can have its onset at the time of strep infections and that as the infection fades, the trichotillomania fades, and when there is another strep infection, the trichotillomania can get worse,” Halper said.

 McLaughlin has had frequent strep infection and continues to battle strep throat as an adult.  Now in her 20’s she is finally planning to have her tonsils removed – a surgery that she hopes will contribute to her recovery.

“This is not going to beat me,” McLaughlin said.

If your child frequently gets strep throat, look for pulling behaviors.  The behavior may go away, but it could signal a growing problem.  For more information, please visit: www.trich.org

 

 

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