What is Trichotillomania? 

"Trichotillomania (aka 'trich') is a mental disorder characterized by a long-term urge that results in the pulling out of one's hair."

How can you possibly pull out your own hair?

That's a difficult question...Sometimes I ask myself the same thing. I like to think of it as a really strong sensation of an itch. Do you ever really have to scratch and itch, and find it difficult to resist the urge? Has anyone ever told you not to touch your face, and immediately your nose begins to itch? This is like that...but it is much harder to ignore. At times, if I am trying to resist the urge to pull, my scalp feels like it's stinging or enflamed, and the only way to put that fire out is to pull a hair out. Often, I feel the urge when I'm anxious, creating a feedback loop in which I am anxious because of how much hair I've pulled out, resulting in more hair pulling: a seemingly unbreakable cycle.

However, it is important to understand that my experiences do not represent everyone with trichotillomania. I've made many friends with very mild urges, many with stronger urges, and many who feel very different sensations than I do.  

Is there treatment for trichotillomania?

Ah... another tricky question. Many psychologists, psychiatrists, neurologists and other researchers have worked towards finding a treatment or cure for trich. While there have been a lot of success stories of individuals reducing and even stopping their hair pulling, there aren't really any widespread treatments that work for everybody. Talk therapy is often recommended (usually cognitive-behavioral therapy or CBT), and sometimes medication (typically anti-depressants used for OCD treatment). Support groups may also be helpful, but can sometimes cause individuals to feel triggered or discouraged by comparison. From my experience, I've found it encouraging to journal, check in with myself, find community amongst those experiencing hair loss for a variety of reasons, and most importantly to understand that my journey is unique to me. While I cannot compare myself to others, I also recognize that I am not alone. I hope that this blog brings a sense of community to those experiencing similar difficulties, because hair loss is a burden is easier to bear when the weight is spread amongst many.

What is Alopecia? 

Alopecia, most generally, refers to any type of hairloss on the scalp or body. A lot of times this can be caused by stress, damage to hair follicles, aging, or in my case, an autoimmune disorder. I have what is called "alopecia areata," which is to say that my immune system attacks my hair follicles in random patches. Out of nowhere, I may wake up to find little round bald spots on my scalp, as I have since I was 11 months old. Then there's "androgenic alopecia," a more general form of hair loss that usually starts as thinning along the top of the scalp. Another kind is "alopecia totalis," which causes individuals to lose all of the hair on their scalp. And finally, "alopecia universalis" causes a loss of hair from all areas of the body. Thus, a variety of unique experiences exist amongst those dealing with "alopecia." 

Can alopecia affect your mental health?

Unfortunately, yes. Mental health is commonly impacted by the presence of alopecia. As with other causes of hair loss, alopecia can greatly impact one's self esteem, and cause feelings of uncertainty, anxiety, fear, grief, or even depression. Especially within a society that puts so much pressure on our hair to be our best and/or most defining feature, hair is often deeply associated with our identities. Losing hair can put one's identity into question, which may be experienced as trauma. The pressure to conceal hair loss can also cause anxiety and/or fear of others finding out, or of products wearing off, wigs falling off, etc. It is so important for those dealing with alopecia to have a strong support system, and to seek therapy if needed. This blog is a safe space for anyone struggling with alopecia or any form of hair loss to speak out and become empowered by a community of those with similar experiences.  

Is there treatment for alopecia?

There is still much unknown about the biological causes of alopecia, and thus there is limited medical treatment for the various types of alopecia. Minoxidil (a.k.a. Rogaine) is often recommended, but is only effective at keeping your hair cells in the growth phase, so if hair cells are not able to enter into this phase of the cell cycle, this will not work. Alopecia areata may be treated with oral medication, but is often treated with steroid injections. I've been receiving such injections into various areas on my scalp since I was roughly eight years old, and I can promise you they are not as bad as they sound! While this does not prevent hair loss for me, the injections are helpful in re-activating my hair follicles after they've been attacked, and usually allows them to regrow the hair I've lost. (This is when Minoxidil is most helpful.) Alopecia totalis and universalis have been known to respond to some of the oral medications used to treat alopecia areata, and sometimes experimental drugs are successful as well. Newer drugs are being tested at present for a more promising treatment of these more severe cases of alopecia. Finally, talk therapy, support groups, and even techniques for concealing bald areas can be very helpful to boost self-esteem (though bald is also beautiful!).  

I'm looking to learn more and provide information about other causes of hair loss so that a spectrum of experiences can be documented here. If you or someone you know have experienced other forms of hair loss, please reach out to me at hairmeout43@gmail.com. Thank you!

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© 2020 by Caroline Klein