Possible signs
- irregular patches
- broken hairs of different lengths
- areas within reach of the hands
- tension before pulling and relief afterwards in some people
Hair dermatology · São Mateus, Espírito Santo
Trichotillomania explained
Trichotillomania involves a recurrent urge to pull or pluck one’s own hair, causing breakage and thinning. Compassionate, non-judgemental care is part of the assessment.
Dermatology care
Hair loss deserves diagnosis, not random trial and error
Patches often have irregular shapes and hairs of different lengths. Some people notice the behaviour; others notice only the hair loss or try to hide it.
- The dermatologist evaluates breakage and excludes alopecia areata, ringworm, traction and inflammation. The history may support referral to psychology or psychiatry.
- A clear care plan with follow-up of symptoms and density.
- Care for patients in São Mateus and the Northern Espírito Santo region.
Important: this page is educational and does not replace a consultation, diagnosis or prescription.
Possible presentation
Signs that deserve attention
What may be involved
It is related to impulse-control and behavioural factors. It is not simply a lack of willpower.
Appearance alone cannot confirm the type of alopecia. Pattern, timing and symptoms change the investigation.
Evaluation
How diagnosis is built
1
Medical history
Onset, speed, triggers, illness, medicines, styling habits and family history are reviewed.
2
Examination and trichoscopy
The dermatologist evaluates breakage and excludes alopecia areata, ringworm, traction and inflammation. The history may support referral to psychology or psychiatry.
3
Individual plan
The type and activity of alopecia, together with general health, determine whether tests, biopsy, treatment or monitoring are appropriate.
Care
Treatment depends on the cause
Care is often multidisciplinary, combining behavioural strategies with scalp care. Treatment is individualised and respects privacy and the person’s pace.
Address the origin
Correct or control an identifiable trigger whenever possible.
Protect follicles
Reduce inflammation, traction or progression to protect viable follicles.
Follow progress
Compare symptoms, photographs and density over time without promising the same result for everyone.
When to seek an earlier assessment
Wounds, infection, bleeding, swallowing hair, severe distress or inability to control the urge require professional help.
FAQ · common questions
Questions about trichotillomania
01Is trichotillomania just a bad habit?
No. It is a real condition that can cause distress and injury. Support and treatment are more helpful than blame.
02How is it different from alopecia areata?
Trichotillomania tends to produce broken hairs of different lengths and irregular patches; confirmation requires examination and history.
03Will the hair grow back?
It may when pulling stops and the follicle is not damaged. Repeated trauma and inflammation can make recovery harder.
04Should I see a psychologist or psychiatrist?
Mental-health support is often important and can be combined with dermatology care.
05What can I do while waiting for an appointment?
Note when urges occur, keep your hands occupied and reduce triggers without self-blame. Do not apply irritants to wounds.
References
Information based on medical sources
- DermNet – Trichotillomania
- Brazilian Society of Dermatology
- American Academy of Dermatology Association – Hair loss
Educational content reviewed for patient communication. It does not replace a medical consultation, diagnosis or prescription.