Talk:Trichotillomania/Archive 1

older entries

The entry on treatment needs some cleaning up. The intro doesn't make sense and there are numerous grammatical errors. Vadel

"Trichotillomania is a disorder that manifests in the compulsive urge to pull or pluck one's hair to any significant degree from one or serveral parts of one's body. The term "trichotillomania" is derived from the Greek words for hair (thrix), to pull out (tillein), and mania and was coined in 1889 by a French dermatologist named Hallepeau. The underlying cause is often stress where the hair pulling is a cognitive distraction as a coping response.

One publicized example of acute trichotillomania was when 18-month-old Jessica McClure pulled out much of her scalp hair while awaiting rescue."

-- taken from the Trichotillomannia article, which I redirected here. Should be merged in at some point. Tenbaset 09:30, 18 September 2005 (UTC)

image

I removed this image tag from the top of the article: "

File:Trichotillomanie kopf hinten.jpg

Trichotillomania in a young woman

". It bluelinks, but there is no image there. Herostratus 11:38, 8 January 2006 (UTC)

User 65.247.229.183 said "Removed picture of plucked pubic area until appropriatness is discussed" The older image that was here before was definitally better. The image that was removed recentlly I think fits per Wikipedia:Profanity. It's a fine line though. Maybe we keep that image up until a better one an be found? Lyo 12:15, 8 May 2006 (UTC)

Since no one has objected to putting the image back until something better is found I am going to put the image back. Lyo 12:29, 13 May 2006 (UTC)

the image is to totally inappropriate if no warning is given abou the image, i think it should be taken out. this is wikipedia not newgrounds User:Zergkiller2255 9:43, 13 May 2006 (PST)

From the affected

As one who HAS the problem, I'd like to just ask if there's actually a cure besides the ones mentioned here. I'd like opinions from other people who have it, too.

Also, I think we should change a few things on the article itself, as we know why we do it (or at least most of us do). Well, for one thing, I should know: It sure isn't connected to self harm or OCD.User:Eric55673

It may not be personally connected to self harm or ocd for you but it is for other people [1] Lyo 00:29, 6 June 2006 (UTC)

Sure comes from OCD here, if wanted (XD) reasons include hair in slightly red follicles, ingrown hairs(normally curling in a half loop), smaller broken stubs from previous sessions, hair embedded in or connected with blackheads, and black(like jet black) hairs. For some reason the black hairs seem to come out with little to none resistance when pulled, no pain for the most part, unlike whiter or clear "normal" hairs which are stuck in, break more easily, cause pain normally. A lot of the time they have this little round black thing on the end(that the root?), sometimes underneath they have a small stringy paleish substance sorta like a mix between skin,pus, and silly string about the size of "---" (inside that quote). Btw Lyo your link died, I think we should keep the images in a reference note(kinda freaky), and of all the insanities I got, why this one? Why not pyro, or cannibal, or even gibbering hobo? 69.251.251.2 (talk) 03:57, 2 June 2008 (UTC)Anyomous 11:55:03 1 June 2008 (GMT) Eastern Us/Candadia time(hey 2 year anniversary of Lyos,shweet) <.< X.X sorry I tried, the information is more important right?

As far as what treats it, I have been wondering if anybody but myself has found that vitamins can help. I have trich personally, and I have found that a specific multivitamin helps alleviate the picking. I don't know which vitamin it is exactly that is doing the trick, or if it is the combination of all of them together, I just know that I found something that works, which is why I keep going to the drug store to buy more.Diane iguess (talk) 23:22, 10 November 2009 (UTC)

Contradiction here:

Prozac and other similar drugs, which some professionals prescribe on a one-size-fits-all basis, tend to have limited usefulness in treating TTM, and can often have significant side effects.

And:

Selective serotonin reuptake inhibitors (SSRIs) are commonly used in the treatment of trichotillomania. Antidepressants have been shown to be effective in treating both Obsessive-Compulsive Disorder and trichotillomania.

Which is true?

---

the latter is true. anafranil has been clinically proven to be effective in treating trichotillomania. i'll try to find my references. --larz 09:21, 9 September 2006 (UTC)

Good luck! The research to date is still far too limited for this statement. SSRI's ( and other drugs) have so far shown to be far less effective in treating trich than for OCD and of short term use in some cases only, mainly effective to assist during therapy. For a good overview have a look at Dr Carol Novak's conference notes on Medications in Trichotillomania here: http://home.intekom.com/jly2/ttmmeds.htm

ruthcrh

Britney Spears

Worth a mention here? Does this extend to include the desire for head-shaving? —The preceding unsigned comment was added by HisSpaceResearch (talk • contribs) 14:37, 24 February 2007 (UTC).

Head shaving is not linked with Trichotillomania. Head shaving is a haircut than an ocd.86.138.223.251 10:34, 27 February 2007 (UTC)

Yeah, we're not that brand of crazy... ;) But seriously compulsive grooming can be an OCD. Not that I think that's what she was up to.

No one has ever said that she may have trichotillomania. But some sufferers cut/shave their hair to avoid pulling.--Asjkfdsl 16:44, 15 May 2007 (UTC)

Beneficial treatment

The most beneficial avenues of treatment available to sufferers thus far have been:

A. A food restrictive diet (such as the John Kender Diet)which requires the elimination of certain foods from the daily menu, including but not limited to most, if not all, forms of sugar (including honey), caffeine, legumes, some nuts, several fruits (fresh and particularly, dried fruit), artificial sweeteners (perhaps with the exception of stevia), etc.. There's a link to other possible foods below. Actual foods to avoid depend on the experimentation of the sufferer.

B. Behavioral techniques such as relaxation response, adequate sleep and exercise, and replacement behavior, such as hair-brushing or other activities involving the hands.

Websites worth reviewing:

http://home.intekom.com/jly2/ttmdiet.htm

http://home.intekom.com/jly2/indexp1.html

http://soul4ce.home.texas.net/index.htm

http://www.trichotillomania.info/

67.80.75.211 21:12, 8 April 2007 (UTC)

Sorry, I'd like to see some kind of clinical study or research before people start promoting their own "trich diets". Anecdotal "I think this diet is great" statements aren't enough. Where's the science? Famousdog 15:52, 10 April 2007 (UTC)

Famousdog is right. Not much scientific research is being done on this ailment. Psychology and psychiatry are questionable fields without biological or chemical research science to back them up, so when I wrote the above comment I figured adding it was at least as valid as having what's already on the page regarding "treatment". I'm not connected to the webpages nor to the people who provided the diet but they point to a popular alternative not yet mentioned. I'd like to see some studies too. But until there is valid medical research on this ailment, adhering to a diet that restricts sugar and caffeine is, thankfully, neither strange nor harmful. It has quelled this ailment and made a remarkable difference in my life as well as those of others in cases where pharmaceuticals have not proven to do the same.Switchboard27 19:13, 10 April 2007 (UTC)

Glad you think I'm right, but I take issue with your unsubstantiated and prejudiced assertion that "Psychology and psychiatry are questionable fields without biological or chemical research science to back them up." What utter bullsh*t! Have you been getting your 'facts' from Tom Cruise? Famousdog 14:00, 11 April 2007 (UTC)

Your disparaging remarks notwithstanding, you can take issue with my assertion if you like. If the treatment claims in the article are based on those two fields being regarded as "sciences", then I'll keep my predjudice. If pills will do you for other conditions, that's fantastic. I'm not a scientologist, I'm a scientist and I hope one day soon someone will do some real medical research on the treatment of this ailment. So far it's severely lacking.Switchboard27 13:22, 15 April 2007 (UTC)

I think you might want to include something about the fact that some people believe that diet, sleep, stress-management, etc, effects it. It's not unencyclopedic to state that people have unsubstansiated theories as to what works. Actually, stating that such theories exist and ARE UNSUBSTANSIATED would be quite encyclopedic... —Preceding unsigned comment added by 208.100.203.208 (talk) 05:43, 27 September 2007 (UTC)

i have an issue with this

"Eyelashes have been reported to grow back thinner or in much lesser amounts." One, this doesn't have a citation. Two, from personal experience, after pulling out all my lashes, it takes 2 months for the lashes to grow back, but they do all grow back, just as long and thick as they were before. The first 6 weeks, there is no noticable growth, but after that it only takes about 2 weeks for them all to grow back in. The problem is that the growing in process is very itchy and irritating, and most trichsters(a word i made up, pretty cool eh?) can't stand it so they pull them out as fast as they grow in. I am a cyclic stress puller, so I end up pulling all of my lashes out about 4 times a year. 1 have been doing this for about 6 years and they have always grown back. So anyway. This claim bothers me, and I think it should go away.

Its been tagged for a while, so I'll get rid of it and wait for somebody to protest. Famousdog 21:48, 9 May 2007 (UTC)

Hey dog, Trichster is a word the Trichotillomania Learning Center has been using for YEARS. Good try though. —Preceding unsigned comment added by Mmoydell (talk • contribs) 03:10, 29 November 2007 (UTC)

Sources

It has been stated that we need to cite sources. Problem is, there aren't many out there, and some of them are sources that have been verbalized to us (Wiki editors). What should we do? --Asjkfdsl 16:47, 15 May 2007 (UTC)

Actually, there is a lot of information out there and a lot of it is open access. Try Google scholar (although be careful as GS takes an inclusive attitude to scholarly publications and some sources it throws up are pretty dodgy). If you can't find a source for some assestion, then it shouldn't be on this page as it might hurt somebody's chances of recovery. Famousdog 14:13, 18 May 2007 (UTC)

Hair regrowth

Taken from characteristics: "Prolonged pulling may affect hair pigment, resulting in white hair regrowth. Permanent hairloss (traction alopecia) has been reported from extensive pulling."

I believe the white hair regrowth was mixed up with traction alopecia, which happens to be an autoimmune disease and cannot be caused by extensive pulling. Unless I'm wrong, in which case source and put back in the article. Absentis 02:30, 12 August 2007 (UTC)

You're probably right; I wouldn't count on anything that isn't sourced to peer-reviewed literature to be accurate here. SandyGeorgia (Talk) 02:32, 12 August 2007 (UTC)

Medications For Treating Trichotillomania

I've removed the following content which was added to the wrong place, is not written in encyclopedic tone, and is not sourced to a reliable source. SandyGeorgia (Talk) 04:09, 5 December 2007 (UTC)

Certain medications are considered for treating trichotillomania. However, it is interesting to know that although medications may assist people to stop pulling one’s hair, the effect is just temporary. There is a great chance for the symptoms of this disorder to reappear. In this case, a behavioral therapy is still deemed necessary. According to some experts, the therapy should be incorporated into the medication treatment.

Here are few of those commonly advised medications for trichotillomania:

Valproate (Depakote) Lithium Carbonate (Eskalith, Lithobid) Paroxetine (Paxil) Fluoxetine (Prozac) Sertraline (Zoloft) Fluvoxamine (Luvox) Clomipramine (Anafranil)

• Paroxetine(Seroxat) is useless in treating trichotillomania, it does wonderful job on depression and OCD(take 2 pills for OCD and 1 for depression) but not for this. —Preceding unsigned comment added by 132.206.33.125 (talk) 22:25, 27 May 2008 (UTC)

Hypotherapy content removed

I removed the following content for discussion:

Hypnotherapy, coupled with neuro-linguistic programming (NLP) techniques, has also proven successful in treating trichotillomania. A hypnotherapist can help the patient to regain the confidence and control they need to overcome the hair pulling obsession.

The source cited does not say that hyponotherapy has proven successful in treating trich, nor would this sort of source prove such an assertion. Proof that hypnotherapy successfully treats trichotillomania would need to come from controlled published blinded studies, not a newspaper account of one person's anecdotal claims. SandyGeorgia (Talk) 14:47, 25 February 2008 (UTC)

Characteristics

As one with Tourette's (and OCD), I find it both offensive and incorrect to lump a GENETIC disorder like TS with "impulse control disorders" like body dysmorphic disorder and, especially, kleptomania. The kleptomania page doesn't mention "genetic", and the TS page doesn't mention "impulse". TS does NOT involve "impulse control" unless you consider having an itch that needs scratching an 'impulse' (and an 'itch' is exactly what the urge to 'tic' feels like, NOT having a DESIRE to go steal something). While it's possible (speaking *strictly* from my personal experience living with both TS and OCD) there is an OCD-based component involved in all these disorders, to imply kleptomania and TS are closely related, without a specific citation, has NO place in Wikipedia. --Grndrush (talk) 05:51, 6 March 2008 (UTC)

• There is a citation suggesting this link has been questioned, which does in itself suggest the link exists (in the eyes of some researchers)Caissa's DeathAngel (talk) 06:26, 31 March 2008 (UTC)

External links

I have removed the external links on this page, wikipedia is not the medium with which to promote support groups. The removed links are below and should only be re-instated if the general consensus on this talk page proves that they are not in violation of WP:EL.

• Trichotillomania Learning Center: national nonprofit organization
• The Uk and Ireland Trichotillomania Support Group
• Trichotillomania/Archive 1 at Curlie
• Psychiatric Times article

Jdrewitt (talk) 18:23, 16 April 2008 (UTC)

I concur that the support groups shouldn't have been there, but have restored the DMOZ and psychiatric times, per WP:EL, WP:NOT and WP:MEDMOS. SandyGeorgia (Talk) 21:56, 16 April 2008 (UTC)

Page Rewrite needed?

"Depression or stress can trigger the trich" lol —Preceding unsigned comment added by 67.162.214.240 (talk) 02:54, 23 November 2008 (UTC)

self injury

Trichotillomania is not a form of self injury. To include it as such is to undermine the severity of self injury: cutting, burning, para-suicide. While the boundary may be blurred between self injury behaviours and compulsive behaviours such as nail-biting and hair-pulling, to confuse them undermines the meaning, purpose, and severity of both. Hair-pulling and nail-biting may cause pain and injury but this is not their purpose: the purpose is pleasure and comfort. For people with trichotillomania, hair pulling is intensely pleasurable (like scratching an itch) and resisting the compulsion to pull is intensely frustrating. Thus, the habit is self contained and cyclical - although emotion may be present, there is no requirement for emotion as a trigger. There is also no link with abuse or trauma: trichotillomania affects children from happy and secure homes as well as those from dysfunctional or abusive backgrounds. Trichotillomania appears to have a genetic factor: it runs in families without being explained by modelling or learning. If you wish to include trichotillomania as a form of self harm, then you must also include nail-biting and thumb-sucking. These latter are close to trichotillomania in intent and effect, and also involve bodily injury. It is clear, however, that to include these as self-injurous behaviours undermines the category of 'self injury' as a management strategy for people recovering from severe emotional trauma. I think that there is currently a lot of confusion about the categorisation of trichotillomania, confusion which will hopefully be resolved with further studies as it recieves more attention within psychology, psychiatry and medicine. see phobic.org.nz —Preceding unsigned comment added by Gherti (talk • contribs) 00:31, 20 May 2009 (UTC)

self injury

Trichotillomania is not a form of self injury. To include it as such is to undermine the severity of self injury: cutting, burning, para-suicide. While the boundary may be blurred between self injury behaviours and compulsive behaviours such as nail-biting and hair-pulling, to confuse them undermines the meaning, purpose, and severity of both. Hair-pulling and nail-biting may cause pain and injury but this is not their purpose: the purpose is pleasure and comfort. For people with trichotillomania, hair pulling is intensely pleasurable (like scratching an itch) and resisting the compulsion to pull is intensely frustrating. Thus, the habit is self contained and cyclical - although emotion may be present, there is no requirement for emotion as a trigger. There is also no link with abuse or trauma: trichotillomania affects children from happy and secure homes as well as those from dysfunctional or abusive backgrounds. Trichotillomania appears to have a genetic factor: it runs in families without being explained by modelling or learning. If you wish to include trichotillomania as a form of self harm, then you must also include nail-biting and thumb-sucking. These latter are close to trichotillomania in intent and effect, and also involve bodily injury. It is clear, however, that to include these as self-injurous behaviours undermines the category of 'self injury' as a management strategy for people recovering from severe emotional trauma. I think that there is currently a lot of confusion about the categorisation of trichotillomania, confusion which will hopefully be resolved with further studies as it recieves more attention within psychology, psychiatry and medicine. see www.phobic.org.nz —Preceding unsigned comment added by Gherti (talk • contribs) 00:33, 20 May 2009 (UTC) Gherti (talk) 00:36, 20 May 2009 (UTC) Gherti

While I agree that there is much to be decided in terms of the organization and categorization of trichotillomania, removing the mention of it being self-injury is unwarranted. Overwhelmingly in literature, trichotillomania is referred to as self-injurious. Abuse and trauma are not requisite for an action to be considered self-injurious. Non-suicidal self-injurious behavior (as noted on the Columbia Suicide Severity Rating Scale) can be for purely manipulative or for attention-getting reasons. There would need to be significant literature to suggest trichotillomania is not self-injurious, especially light of its ubiquitous use in describing the mania. Self-injury is not just a management strategy for people recovering from severe emotional trauma. see http://www.helpguide.org/mental/self_injury.htmZach99998 (talk) 09:11, 25 May 2009 (UTC)

Variation in hair

My hair is both translucent and thick/thin. At one side of the scale, some hairs (maybe 10 percent) were really thick, red and curly, almost like pubic hair. And at the other side of the scale (maybe more than 20 percent) hair was blonde, thin and straight. The rest of the hair is inbetween, with variation from golden to blonde and some thin, some pretty thick, some straight, some had a kink in it. I pulled virtually all of the really thick, red and curly hair, because I hated it. But I don't have any bald patches on my head, But I pull a lot of my pupic hair out, cause most of it is like this. I mean, I would never have pulled the thin/blonde hair out. It was only the thick and red hair I didn't like. Anyone ever heard of this? 80.41.37.219 (talk) 22:30, 25 June 2009 (UTC)

not self injury or OCD, new effective treatments, common causes

The current definitive classification of hair pulling as OCD in the first paragraph is misleading when it is not a universally agreed upon classification. Experts, and those experiencing Trich, are increasingly concluding that a growing body of evidence supports it falling somewhere between an addiction and habit - like nail biting - since the needed symptoms to classify Trich as OCD are not present.

Also, the therapy recommendations currently listed here are heavily skewed towards specific types of drug therapy. Less than 10% report this behavior is significantly helped or cured with drug therapy. Stronger evidence supports cures over time with adaptive 12 step programs and counseling around family issues. Some individuals have become pull-free with hypnotherapy, vitamins and amino acids, prayer, talk therapy, behavioral therapy, support groups and using physical barrier methods (such as hats, gloves, etc.) during stressful times to help break the addictive response cycle.

The majority of former Trich sufferers report the most successful treatments include resolving underlying emotional conflicts and coping with traumatic experiences or difficult family situations, improving self esteem, and replacing addictive thinking patterns with updated beliefs. Common sources of stressors that may result in Trich becoming a coping response include childhood trauma, family anxiety or an out-of-control parent relationship in the child's early life. (See sources, expert opinion and supporting testimony at dailystrength.com, trich.org and others.)

Newposting71 (talk) 07:36, 21 September 2009 (UTC)

Please see WP:MEDRS; information added to medical articles on Wikipedia should conform with Wiki's sourcing policies, and the websites you have listed do not. If you have sources that conform with WP:MEDRS for the information you would like to add or change, please supply the sources. SandyGeorgia (Talk) 15:50, 21 September 2009 (UTC)

Reviews

Recent reviews, full text available online, conform to WP:MEDRS:

• Sah DE, Koo J, Price VH (2008). "Trichotillomania" (PDF). Dermatol Ther. 21 (1): 13–21. doi:10.1111/j.1529-8019.2008.00165.x. PMID 18318881.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Chamberlain SR, Menzies L, Sahakian BJ, Fineberg NA (April 2007). "Lifting the veil on trichotillomania". Am J Psychiatry. 164 (4): 568–74. doi:10.1176/appi.ajp.164.4.568. PMID 17403968.{{cite journal}}: CS1 maint: multiple names: authors list (link)

SandyGeorgia (Talk) 13:55, 27 November 2009 (UTC)

Dubious hypnotherapy claim

This text was added, sourced to a 1996 and a 2003 review, neither of which are available online. The two more recent reviews already cited in the article (listed above, 2007 and 2008, and available online) do not mention hypnotherapy. Unless a recent review indicates hypnotherapy is useful, this text should be removed per WP:UNDUE and WP:MEDRS. SandyGeorgia (Talk) 20:52, 15 December 2009 (UTC)

I have a copy of one of the two reviews. And yes I agree it is dubious. From this paper "Hypnosis may improve or resolve numerous dermatoses. Examples include acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. Hypnosis can also reduce the anxiety and pain associated with dermatologic procedures". PMID 12919113 Doc James (talk · contribs · email) 20:54, 15 December 2009 (UTC)

That's a 2003 paper; hypnosis is not mentioned at all in more recent reviews. Can you please add what the author of that old review is citing when this claim is made? SandyGeorgia (Talk) 21:00, 15 December 2009 (UTC)

I do not have any strong feeling either way about removal. This resulted from a discussion at Wikipedia_talk:WikiProject_Medicine#Trichotillomania I have sent you a full copy of the paper. I am not impressed by its quality :-) Doc James (talk · contribs · email) 21:01, 15 December 2009 (UTC)

SandyGeorgia, before you "stick" this on me please examine the edit history: that text was not added by me; it was restored by me. I added sources. I am sympathetic to the plight of the newbie editor who just got blocked over this rather trivial matter; how is this editor supposed to learn to edit constructively when more experienced editors model revert warring? I am dubious about hypnotherapy myself, however I know it is not our job to judge but rather to fairly report information from reliable sources. I will leave now with this question: in what way does an article that does not address X in any way debunk X? --Una Smith (talk) 21:04, 15 December 2009 (UTC)

You restored text, means you added it. And you added old sources. We don't teach a new editor about WP:UNDUE and WP:MEDRS by violating them; we explain the problems and correct sourcing on talk. Unless someone has a new review that mentions hypnosis, I suggest that you, Una, revert the text that you added. SandyGeorgia (Talk) 21:07, 15 December 2009 (UTC)

I think explaining all the treatments that are poorly supported by evidence is an important aspect of Wikipedia. We than do not leave a vacuum for people to come along claiming there is more evidence than exists for certain treatments. Neither of these reviews that "supported" hypnosis did no very vigorously. And mentioning the fact that newer reviews do not mention than will hopefully put the issue to rest. If a section of no supported treatments becomes too long than just split it off and summarize.Doc James (talk · contribs · email) 21:11, 15 December 2009 (UTC)

That approach would be original research and synthesis; we don't mention that new reviews don't mention it. We simply prefer new reviews over old reviews, and should only state about each treatment what the reviews actually say; we can't just make it up, even based on what they don't say. SandyGeorgia (Talk) 21:13, 15 December 2009 (UTC)

Yes but you have to mention the pseudo science to debunk the pseudo science. Maybe quackwatch has something? Doc James (talk · contribs · email) 21:17, 15 December 2009 (UTC)

I'm sure someone will full journal access will come up with something soon enough; in the meantime, it's unfortunate that such clearly dubious text was added to the article, rather than discussed on talk. SandyGeorgia (Talk) 21:21, 15 December 2009 (UTC)

I agree with Doc James that all therapies deserve mention, not just the top flight therapies. I think that is especially in dermatology articles; the field is chock full of dubious treatments, many not even supported by case reports. Here are some sources from Google Books, using the search term "hypnosis" only, not "hypnotherapy":[2][3][4] They are from the first 2 pages of search results. A couple of them state that evidence for the usefulness of hypnosis/hypnotherapy is entirely from case reports. There are no controlled studies. I think there are enough case reports, from enough different authors, to merit saying hypnosis is widely used. Clearly it has not been established that hypnosis is useful, nor that it is not useful. --Una Smith (talk) 21:25, 15 December 2009 (UTC)

Here is the entire text about trich in the cited article (PMID 12919113), and the data it is cited to. This very brief and speculative text, based on case reports and very old studies, does not rise to the level of something we should be reporting in this article, particularly when newer reviews do not even mention hypnosis. Since we don't have a review that mentions that hypnosis is dubious, claiming it is would be original research. By adding that text, you have given undue weight to a dubious treatment based on outdated reviews. The text you are proposing is also original research; we report what sources say, or don't say; we don't make it up.

Several reports of successful adjunctive treatment of trichotillomania have been published (64–66). It appears that hypnosis may be a useful complementary therapy for trichotillomania.

• 64. Galski TJ. The adjunctive use of hypnosis in the treatment of trichotillomania: a case report. Am J Clin Hypn 1981: 23: 198–201.
• 65. Rowen R. Hypnotic age regression in the treatment of a self-destructive habit: trichotillomania. Am J Clin Hypn 1981: 23: 195–197.
• 66. Barabasz M. Trichotillomania: a new treatment. Int J Clin Exp Hypn 1987: 35: 146–154.

Further, unless I've missed something, the two sentences above are *all* the article says about trich, so the text currently in the article is wrong. All we can say, based on this old data, is that older published reports suggest that hypnosis may be a useful complementary therapy, nothing else. SandyGeorgia (Talk) 21:40, 15 December 2009 (UTC)

We can also make a much smaller claim: that hypnosis has been used as a treatment. This eliminates any need to determine whether or not it produced clinically significant improvements in a statistically significant proportion of treated people (i.e., that hypnosis is useful as a treatment). WhatamIdoing (talk) 01:47, 16 December 2009 (UTC)

Before Wikipedia deletes my account again

I made an entry earlier,and apparently my one single contribution to the website does not amount to much, so my account was deleted. I will try this again. I have trich, have had it for many years, and only recently found something that helps. The recession has proven to have its upside, one of which being that I saw a pop-up once that advertised one of the B vitamins as being good for stress. I went to the local pharmacy and bought some, but it did not stop the hair-picking. I went online and found other vitamins that are good for stress, and decided to try one, which still did not work. Since I only work part-time and cannot afford to buy one of every bottle sold, I started buying multi-vitamins and I found one that works, or at least, it works for me. I wanted to post this in case it can be of help to anyone else. I have not seen anything that states that trich comes from a vitamin deficiency, but this is worth a try. I do not have the ability to isolate the different vitamins individually, so I will simply list all of them. The multi-vitamin came from Wal-Green's, under the brand name "Finest" "B-Complex with Vitamin C." Ingredients are:

• Vitamin C 300 mg
• Thiamin 15 mg
• Riboflavin 10.2 mg
• Niacin 50 mg
• Vitamin B6 5 mg
• Pantothenic acid 10 mg

I do not know if it is maybe one single ingredient, or if it is the combination of something, I just know that if I take one of these every day at the same time of day with food, I do not have any desire to pick at my hair. Diane iguess (talk) 18:10, 5 April 2010 (UTC)Diane iguess (talk) 18:32, 15 April 2010 (UTC)

Hair pulling redirects here

"Hair pulling" redirects here - surely hair pulling is a much bigger topic encompassing bullying, sexual fetish etc, not limited to Trichotillomania? Thanks --Irrevenant [ talk ] 01:59, 5 June 2010 (UTC)

I typed in hair-pulling too, expecting it to lead to some article about fighting, or even specifics about how hair-pulling can be used as a fighting technique (i.e. something to do with the catfight article).. but how the hell did I end up reading this medical crap instead? Mac Dreamstate (talk) 04:00, 17 December 2011 (UTC)

Sleep Isolated Trichotillomania

I notice that there is nothing relating to sleep at all in the article, let alone an account of Sleep Isolated TTM. These ideas are found in numerous published articles relating to the subject. Would this be worth an edit to the article?

Touvemn1 (talk) 20:24, 14 June 2010 (UTC)

I have reverted again; this information is not included in any secondary review that I can find, and Wiki medical articles shouldn't report primary studies. Please read WP:V, WP:RECENTISM and WP:MEDRS- if you can locate a secondary review that includes this notion, it should be sourced to that, otherwise, doesn't belong here. On the support group, I re-added it as it is specifically mentioned in the most recent secondary review. SandyGeorgia (Talk) 12:55, 8 July 2010 (UTC)

What support group are you talking about?--Clipovsky2010 (talk) 16:18, 9 July 2010 (UTC)

This edit removed info sourced to a secondary review; I restored it. SandyGeorgia (Talk) 02:51, 10 July 2010 (UTC)

Decoupling

Hello, I would like to discuss the topic of my contribution regarding decoupling, a variant of Habit Reversal Training. SandyGeorgia, you have deleted it twice, always with the reasons WP:MEDRS and WP:RECENTISM. I understand why you are dealing with my input in this way, but I contradict the correctness of your point of view. WP:MEDRS says that if there are no secondary sources, because the issue is new, then you can cite a primary one. This is only constricted by WP:RECENTISM.
So, my point of view is that in this case, I did not add a totally new and contrary finding that tries to denigrate the previous therapy options. I did not put something in the article that is only justified by e.g. being written in the Sun and now everyone wants to know something about it like Paris Hilton. The latter I would also call really recentish. ;-) In this case, my contribution should be understood as short information on a new specialized kind of HRT. Until now there are no other primary or secondary sources yet to underline these findings. Yes, I know, this is the problem. But: The new study is peer-reviewed and accepted in a journal with a good reputation and with an impact-factor of 2,483. Here is the DOI. Here is the link to the journal itself. We are talking about a disorder where people suffering from TTM have currently only very few treatment options and I think it is not only good but also our responsibility to make these aware to the public once they have been scientifically evaluated which is the case here. WP:RECENTISM suggests the ten-years-question in “Suggestions for dealing with recentism”. I would say: Yes, this topic on decoupling can easily be more relevant in ten years then now. Another suggestion is: “Just wait and see!” So...
This contribution about a new therapy option will not harm anybody, it does not try to promote anything weird or something influenced by some bad Lilly-Pharmacy-lobbyist or anything like that. It is just the try to show the non-medical readers, especially the patients, one additional little opportunity to deal with the disorder. I would say it is admissible and justified to let me contribute to this article the way I did. I do not want to be disrespectful but I think that it is not reasonable to refuse decoupling just because of sticking to the rules literally...

Thanks in advance to hear about your thoughts, kind regards, Neuschrank (talk) 11:03, 15 July 2010 (UTC)

WRT Paris Hilton, medical articles should not include unreviewed primary studies that are 1) not yet even published, and 2) not reviewed by secondary reviews, and 3) reported in the popular press, which usually gets it wrong (see WP:RECENTISM and WP:MEDRS). It is *not* our responsibility to mislead or inform our readers of unproven primary studies. Further, your edit added promotional spam ("The self-help technique is available online at no cost: http://www.uke.de/impulskontrolle"). If you can gain consensus for this addition at WT:MED, it can perhaps be included. I suggest looking for published, PMID-indexed, secondary reviews discussing decoupling in general, and adding that to the HRT article if they exist, but they have no place here. SandyGeorgia (Talk) 13:42, 15 July 2010 (UTC)

Dear SandyGeorgia, you seem to apply double standards here. For example, the wikipedia article also cites other single studies. Just two examples from the site: "One study showed that individuals with TTM have decreased cerebellar volume" or "N-acetyl-L-cysteine (NAC) taken as a supplement has shown suppression of the urge to pull hair in a small clinical study". Regarding the "promotional spam": I understand why you have the impression like that, but I would like to say that it was not my intention to promote something but to give access to the manual, because I appreciate the fact that patients don't have to pay for this in book-form. But I really see that my phrase was a little irritating and you may rest assured that this was not my intention. So, regarding this missunderstanding of my aims and the way other studies are used in the article, I certainly will delete the web-link and delete the second sentence but since the study has been accepted for publication in a prestigious journal following peer-review routines it has the same right to be cited as studies which found your mercy. Kind regards, --Neuschrank (talk) 18:06, 15 July 2010 (UTC)

Hi, I agree that the sentence should be removed. I have accessed the article and read it; it is a highly preliminary internet-based study, that spends almost two full pages describing the project's limitations, including that the subjects were not even seen to ensure that they actually had the disorder. It concludes that "[T]he results should be interpreted with caution unless independent replications and long-term follow up studies using expert ratings are conducted. Future studies may also employ descriptions of control techniques of approximate length...." and it goes on and on about needing to assess the safety of the procedure, that the tx may create other stereotyped behaviours, and questions about whether the results were maintained. I could go on, but I think that is enough to show clearly that this is very early primary study with admitted multiple methodological flaws, thus certainly is inappropriate per WP:MEDRS. I will be deleting the sentence.--Slp1 (talk) 22:15, 15 July 2010 (UTC)

Too late. It has already been deleted by another editor.Slp1 (talk) 22:19, 15 July 2010 (UTC)

Agree with the above editor. We need a review article before we mention it. Doc James (talk · contribs · email) 22:22, 15 July 2010 (UTC)

I've read it too, and concur. It is too early. Anthony (talk) 22:27, 15 July 2010 (UTC)

I think we should be careful not to give the impression that no primary study is ever acceptable. Rather, we should emphasize that primary studies must be used with care, and also subject to the guidance in WP:RS which urges us to reflect minority viewpoints with due weight. In fact, in this case, given the quantity of good secondary sources, the reason that a small recent primary study need not be mentioned is precisely one of undue weight. If the study were independently replicated, perhaps on a larger scale and with increased rigour, then I suspect that the findings would start to "appear on the radar" as far as due weight is concerned. Indeed, at that point, such findings would be expected to appear in the next round of reviews. I should add that I have difficulty in discriminating between "decoupling" and the "competing response training" component of habit reversal training. I would really expect studies to have to differentiate more explicitly if DC is to be acknowledged as distinct from HRT. --RexxS (talk) 23:25, 15 July 2010 (UTC)

Dear all, I give up. Still, would someone be so kind and explain why my contribution is deleted and single studies like "N-acetyl-L-cysteine (NAC) taken as a supplement has shown suppression of the urge to pull hair in a small clinical study" are not (only one example). I do not think that Slp1 gave a fair summary of the article and was overly polemic. The article presents an internet study on a self-help technique for TTM. Following pre-assessment, participants were either randomized to an experimental or control group. Four weeks afterwards, outcome was measured with standard scales (e.g. MGH-HPS) - already assessed at baseline. A significant decline occured in the experimental (DC) relative to the control group. Due to the internet design (chosen according to the authors to reach patients at a low threshold) subjects were not formally diagnosed with TTM but control questions and the choice of forums ensured a high quality. I think that these results are promising and worth reporting especially in view of the large treatment gap in TTM: As many people with TTM do not seek or get active treatment and the manual is provided at no cost at the internet why not mention it...? Regarding "promotional spam": Why are you so offensive, SandyGeorgia? The manual is provided at no cost to help people with TTM. Again, I give up... --Neuschrank (talk) 13:25, 21 July 2010 (UTC)

The study does have significant limitations, acknowledged by its authors. Slp1's assessment is fair. Wikipedia medical articles can't report this. Thank you for pointing out the NAC insertion. I have deleted it for the reasons you cited. I understand your disappointment, but medical articles here have to comply with policy. (Some single studies may be mentioned in med articles once they have been assessed in an authoritative review article.) Anthony (talk) 14:33, 21 July 2010 (UTC)

I agree with you, Neuschrank, that a self-help treatment that treats people with TTM is worth reporting (but Wikipedia is not the place for the initial reports). Once reliable reports have been made in secondary sources, it would then be worth including in an encyclopedia. I hope you can see the difference. Consider this: if Wikipedia were to take on the task of informing the world about every possible suggested medical treatment (proven or unproven), where would it end? We are trying to build a respected encyclopedia, and WP:MEDRS along with WP:UNDUE help us to establish what should be included. Nobody here is criticising the internet site that attempts to help those with TTM, or denigrating the efforts of those concerned. But consensus dictates that it's not significant enough yet to warrant a mention on Wikipedia. Should DC prove as effective as you think, it will receive coverage in the next round of reviews, and then would be suitable for inclusion here. --RexxS (talk) 15:01, 21 July 2010 (UTC)

Clarification?

Does this topic include pulling out nose or ear hair? or compulsive removal of hair missed whilst shaving? The Yowser (talk) 13:01, 10 January 2011 (UTC)

I'm not sure if it includes hair missed while shaving, but it includes hair in other places. I have trichotillomania and I used to pluck all my eyelashes and eyebrows; nowdays I've mostly managed to redirect it to plucking out all the hair in my armpits. I'd reached this stage when formally diagonosed. So if armpit hair counts then nose or ear probably does too. 203.59.114.144 (talk) 17:10, 27 August 2011 (UTC)

Yes, nose and ear hair counts, assuming it is being pulled compulsively, and not simply as a grooming technique. I also have trichotillomania. Primary target areas for me include nose hair, eyebrows, sideburns, and yes, even a hair missed while shaving. (One missed hair on my face, once discovered, will antagonize me until I manage to pull it out. If a mirror and a proper pulling implement aren't available, the result of blindly using my fingers will often include skin irritation, blood, etc.) BroWCarey (talk) 22:58, 27 August 2011 (UTC)

Inconsistency?

Hi, I just discovered this article, after discovering shortly before that that this is the name for what I do. (Or is it?) Specifically, I pluck (using fingernails or tweezers) hair from my nostrils, eyebrows, ears, and/or beard (when I have one). I'm not sure whether to call it "compulsive" (I would compare it to scratching an itch--I can stop if I want), and it certainly hasn't adversely affected my life. Yes, the thicker hairs are more inviting. Yes, it causes something like a sense of relief. The behavior began when I was around 20.

Now the first paragraph defines trichotillomania as compulsive behavior, and as a disorder. The "Classification" section omits any mention of compulsion, and refers simply to the feeling of gratification or relief. Is this an inconsistency? I suppose that a "mania," by definition, would have to be some sort of disorder, otherwise we would have to change the name to "trichotillophilia" or something. (As an analogy, consider the difference between sex addiction and ordinary interest in sex--which typically does involve a sense of gratification!) Since many people dipillate as a grooming method (e.g. Joseph Lieberman, who does it for religious reasons), it seems perverse to say that they are normal unless they get any pleasure out of it, in which case they are crazy! --Dawud — Preceding unsigned comment added by 111.240.183.105 (talk) 13:33, 10 February 2013 (UTC)

SSRI Treatment Efficacy

Linked study investigates literally only fluoxetine. I recommend removing reference to "other [SSRIs]and rewording and/or removing reference to "significant side effects" as this phrase appears to me to suggest some level of side effects specifically due to the use of SSRIs for this particular condition. Whereas, the cited study mentions side effects typical of the SSRI class in general. — Preceding unsigned comment added by 206.210.120.178 (talk) 22:27, 13 June 2014 (UTC)

Lead needs rewriting

The lead sentence - Trichotillomania is a disorder "leading to noticeable hair loss, distress, and social or functional impairment", and is "often chronic and difficult to treat". - is bereft of specific meaning to the point that it seems as though discussion of the cause must be taboo. In fact, the only mention of the cause at all, and in a very oblique manner, is in the etymology - ...till(en) (to pull)....

Perhaps better would be Trichotillomania is a disorder characterised by the pulling out of one's own hair "leading to noticeable hair loss, distress, and social or functional impairment", and is "often chronic and difficult to treat".

Or perhaps even drop the quotes, which are, respecively, self-evident and a fact. What about Trichotillomania is a disorder characterised by the pulling out of one's own hair. It is often chronic and difficult to treat.

I'm hesitant to make the changes myself as my knowledge of the pathology of the disease is purely inferential. I don't know, for example, whether or not 'pulling' adequately describes the behaviour (does it include cutting hair, or slamming hair in doors?). I do, however, think that it needs to be clarified. 118.209.89.140 (talk) 16:25, 20 November 2010 (UTC)

This piece is also written poorly: "common areas for hair to be pulled out are the scalp, eyelashes, eyebrows, legs, arms, hands, nose and the pubic areas". These "common areas" are pretty much every area on the body that contains hair. --97.116.117.225 (talk) 21:03, 16 July 2014 (UTC)

Causes and Pathophysiology

I removed the following that had been added to one of the references (#18): Also studies have been conducted and what follows is childhood abuse. Out of 300 subjects, of the 82 that suffer trichotillomania were abused by the hands of an older male, most likely the father of these subjects. The abuse of a father or mother (parents) suggest that this is a disorder stems from this traumatic portion of one's life. |publisher=Bjp.rcpsych.org |date= |accessdate=2013-02-22}}</ref>

This addition was poorly written, inaccurate and seems misleading. The cited article in the British Journal of Psychiatry cites as its source an earlier article/study published in the Journal of Nursing Scholarship, by Susan Boughn, RN, MSN, EdD, Delta Nu, Professor of Nursing, School of Nursing, at The College of New Jersey, Ewing, NJ and Julie Jaarsma Holdom, RN, BSN, Delta Nu, at The College of New Jersey, 23 April 2004. This study involved 44 female individuals with trichotillomania, not 300, and while most of those had suffered some type of trauma or abuse in their lifetime, and some of that was sexual, the study mentions nothing about the perpetrator being an older male or the father of the subject. The study, like many others, simply addresses possible initial triggers for trichotillomania, that is, what first started it. But it is generally understood from considerable research that these events do not "cause" the disorder. Triggers as innocuous as puberty or moving to a new home have been noted to trigger trichotillomania, leading researches to believe that a predisposition to the disorder already exists, and needs only an event that evokes strong emotions to trigger it. BroWCarey (talk) 13:19, 23 October 2014 (UTC)

External links modified

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Trichotillomania/Trichotillosis

Help me! Karabear1989 (talk) 20:52, 28 September 2015 (UTC)

Stimming

Hi, I just wonder... could Trichotillomania be a kind of stimming? Laurier (talk) 12:43, 18 August 2015 (UTC)

And a related question: do people with autism and/or ADHD have Trichotillomania more often than 'neurotypical' people? - Yes, this seesms to be the case. Perhaps we should mention this in the Trichotillomania-article? Laurier (talk) 13:12, 18 August 2015 (UTC)

Trich can definitely be a form of stimming. BluJay (talk) 02:48, 17 January 2016 (UTC) BluJay (talk) 02:48, 17 January 2016 (UTC)

something related

a girl from Kyrgyzsatn was eating hair, doctors found 4kg hairball inside her. https://uk.news.yahoo.com/doctors-treat-teenage-girl-for-severe-stomach-pains---and-find-hairball-weighing-four-kilos-163319144.html --158.181.156.226 (talk) 21:02, 30 January 2015 (UTC)

It's called a trichobezoar (aka hairball). TylerDurden8823 (talk) 21:22, 30 January 2015 (UTC)

Some people with torch eat the hair they pull, so it could be related. BluJay (talk) 02:49, 17 January 2016 (UTC)

• trich BluJay (talk) 02:50, 17 January 2016 (UTC)

Description

When I search Trichotillomania, the line of script that appears under my search reads 'human disease' trichotillomania is not a disease, but a disorder. Could somebody please change this. Thank you. BluJay (talk) 02:55, 17 January 2016 (UTC)

Devices

I added information previously on a startup producing a trichotillomania-related wearable. The section got deleted for spam reasons and I apologize for that. Given that alert devices are probably a viable treatment, what is the best way to present this information? Would stating that the devices exist without listing any brands, then citing a news article about the creation of such devices be tolerable? Hapanin (talk) 08:28, 8 February 2017 (UTC)