Excerpt from:
Trichotillomania: A Guide, 1994
(45 page guide to understanding what trichotillomania is and how it is treated)

Trichotillomania is a term coined by a French dermatologist in 1889 to describe the compulsive or irresistible urge he saw in patients to pluck out their hair. The word trichotillomania is derived from the Greek thrix, hair; tillein, to pull; and mania, madness or frenzy. This name is somewhat of a misnomer in that people with trichotillomania are not "mad", "psychotic" or "crazy" as the name suggests. In psychiatry, trichotillomania is classified as an impulse control disorder as are conditions such as compulsive gambling, kleptomania (compulsive stealing) and pyromania (compulsive fire setting).

Impulse control disorders are characterized by the inability to control or resist the temptation (or impulse) to do something harmful to oneself or someone else. A sufferer sometimes experiences a sense of increasing tension before performing the behavior and can feel a sense of relief or release of tension afterwards. Sometimes people even express a degree of pleasure after having performed the act.

Features of trichotillomania that fit the description of an impulse control disorder include the inability to resist urges to pull out one's hair, mounting tension before pulling and feeling of relief afterward.

If you would like a copy of the Information packet (130+ pages) compiled by the Trichotillomania Learning Center, Inc. please see membership Information .


DSM-IV Definition
More formally, the fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defines trichotillomania as:

Recurrent pulling out of one's hair resulting in noticeable hair loss.

An increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior.

Pleasure, gratification, or relief when pulling out the hair.

The disturbance is not better accounted for by another mental disorder and is not due to a general medical condition (e.g., a dermatological condition).

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Not all patients who pull out their hair meet these strict criteria. Nonetheless, they frequently have a distressing problem that might very well benefit from treatment.