Joyce Tran
Updated on April 17, 2021

Say it with me. Trick-oh-till-oh-may-nee-uh. Trichotillomania. If you are living with trich, I wrote this guide with you in mind. I want you to walk away with a better understanding of this particular hair-loss disorder. I will share five tips on living with trich that have helped me in my own life. These are things you could easily pass on to your friends who may be experiencing hair loss, themselves.

What Is Trichotillomania?

Trichotillomania is a mental disorder, just as much as it is a hair-loss disorder. Beyond its tricky pronunciation (no pun intended), it is the compulsive urge to pull out one’s hair, which often leads to visible balding or thinning hair.

Someone with trichotillomania may pull hair from their scalp, eyelashes, eyebrows or body hair. The important thing to remember is that the urge is uncontrollable.

As someone who has experienced trich for the past 16 years, I know the search for answers can be daunting. What are the trichotillomania treatments? What causes trichotillomania? How can I stop trichotillomania?

My Trichotillomania Story

I lived with trichotillomania for the better part of 16 years. Trichotillomania in toddlers is common, but most people start developing it during puberty or pre-adolescence. Some people might begin pulling hair out as young as infancy. I started pulling my hair out by the follicle at 9 years old.

I am not a licensed psychologist, but I’ve been deeply researching trich for more than five years. This guide is based on my research and my personal experience as a 23-year-old woman living with hair loss.

First Signs of Trichotillomania

I started by twisting and fiddling with my hair at age 8. Others can start with nail biting, hair twirling, thumb sucking or any other seemingly innocent habit. There is no guarantee that these habits will manifest into compulsive hair pulling (or skin picking, known as dermatillomania), but in my case, it did.

From twirling my hair, I eventually began pulling my hair by the follicle. That means that I would pull a single hair at a time, usually with the goal of removing any coarse or irregular hairs on my head. The sensation of pulling the “right” hair would soothe my anxious thoughts for a split second.

Once that second of relief passes, my fingers are exploring my scalp and looking for the next irregularity to remove.

Besides anxious thoughts, other factors affect my trichotillomania on a daily basis. The universal source of compulsive hair pulling is extremely difficult to pinpoint. As a result, it’s difficult to avoid.

Results of Trichotillomania

When my trichotillomania is left unchecked, I would develop thinness throughout my hair. Depending on the “ideal” pulling spot, these patches would appear thinner than others. My hair has grown unevenly for the duration of my trichotillomania journey.

That meant that I had to style my thin hair in ways to conceal my disorder or lying to close friends and family about the causes of my hair loss.

I would go as far as colouring in my bald spots with eyeliner, wear my hair in a certain updo for months at a time, wear hats when completely unnecessary, bobby pinning my hair into oblivion, and so much more. There is likely a trichotillomania hack that I haven’t tried.

Trichotillomania Hack

Years of Hair-Pulling

Living with trichotillomania for more than 15 years, I have seen my hair exist in seasons.

Sometimes my hair would grow strong and long. My pulling would disappear over the course of a few months. I would be able to braid my hair, style it, and, at face value, show no signs of this complex hair-loss disorder that I have lived with for years.

Other times, I would cut my hair short to curb the pulling. My hair would be uneven, show breakage and feel weak when my pulling felt uncontrollable.

Throughout high school and university, I thought the stress of schoolwork, deadlines and expectations were the source of my hair pulling; and I thought that if I had long hair, I would be happy.

Is Long Hair the Answer?

During my university years, I saved a lot of money from my part-time jobs to try semi-permanent hair extensions. The extensions were micro-weft extensions where a silicone-lined bead would secure a weft of hair to my own hair.

With months of research and several consultations under my belt, I found myself walking out of the salon with new hair installed.

Micro Weft Extensions

This new hair followed me for a total of 8 months. I had the recommended monthly touch-up appointments, and slowly but surely learned about traction alopecia (which you can read more about here).

The longer hair felt great… at first. The constant risk of traction alopecia was stressful as someone with a tender scalp. I would still pull my hair despite the extensions which left my hair thinner and damaged by breakage.

Even after all that, has it helped with my pulling?


The reality is that I still pull my hair every day.

Truly. After 16 years of living with compulsive hair pulling and the subsequent hair loss, I still pull out my hair, and here’s why.

I learned over time that pulling out my hair is something I can rarely control. From a neurology perspective, I spent the past 16 years reinforcing the signal in my brain, “If you feel stress, pull out a hair to relieve the stress.” Having already reinforced that neural transmission hundreds or thousands of times is something extremely difficult to overcome.

That’s why people with trichotillomania cannot “just stop”.

Since I can’t control the frequency of my hair pulling, I decided to control the guilt I feel tied to my hair instead.

Trichotillomania Different for Everyone

If this form of hair loss is tied to psychology, mental health and neurology, how am I supposed to treat trichotillomania? But, overall, what kind of trichotillomania help is available?

There is no particular 9-minute cure, or 10-day program, or 2-month exercise program that will work for everyone. There is no pill, serum or hair mask that you can apply that will make your hair grow back faster than you pull it out. Cell regeneration takes time. There’s no disputing that.

You may have seen trichotillomania bracelets online. These electronic bracelets notify you every time you raise your hand to pull out your hair to bring mental awareness every time you reach to pull.

Because of the inconsistent nature of trichotillomania (which means the experience is drastically different for everyone who has it), there is no way to narrow down a single treatment for everyone.

Extensions didn’t work for me, but it works for others. Tracking my pulling didn’t work for me, but there are others who found great success in it.

For some people, they woke up one day without the urge to pull anymore.

5 Tips for Living with Trichotillomania

For me, shifting my mindset on trichotillomania has been instrumental in my journey of recovery. Here are the small, but mighty steps that have brought me the most peace with my trichotillomania and hair loss.

1. Define Recovery

Your definition of recovery will define your success. Let’s say you define success as being pull-free for a month. If you normally pull your hair every day, imagine how easily disappointed you’ll be. Your goal should align with your current habits. It’s important to set healthy and reasonable goals for yourself.

2. Talk to Someone About It

Suffering in silence is one of the most unproductive things I have done. By hiding my hair loss from others, I never got to confront my hair loss directly. Honestly, it felt like living in denial for a long time.

Once I began attending peer support meetings and opening up online, I came to realize:

You aren’t as alone as you think.

There are people who love you whatever your hair looks like.

Hair isn’t the end of the world.

3. Research Alternative Hair

There are so many hair solutions for ladies with hair loss, on the market now. The key is to find one that works for you rather than against you. Don’t lose sight of the real goal, though. Long hair might be the goal, but there are different ways to approach it.

The semi-permanent extensions didn’t work for me because of the traction alopecia it caused. I would still pull on the extensions, and those extensions were connected to my hair.

Wigs and toppers are more popular than ever, and, depending on your level of hair loss, it could be a solution that works for you.

Now I wear a wig when my hair pulling feels out of control. It protects my real hair from my pulling and gives it a chance to grow undisturbed even if it’s only for a few hours. Being honest with yourself and your needs is a really important step.

4. Take Care of Your Hair

The times where I thought the worst of my hair were the times I cared for my hair the least. Just because my hair was thin, patchy, and partially balding does not mean I should let my hair and scalp go to waste.

Taking the time to take real care of my hair is more important than ever. It reminds me that my hair is important and it’s doing what it can. I’m also regularly trimming my hair rather than avoiding hair cuts, which makes me feel better about my hair, since I’m constantly scared of losing it.

5. Reflect on Your Strengths

Even though you’ve just read through all this hair talk, your life is more than your hair.

When I started coming to terms with my own hair loss, it opened the space in my mind to think about other parts of me and to be grateful for them.

I started seeing the things in myself that have nothing to do with my hair: I’m a great friend. I send amazing memes. I love to hike and drive. I can eat a watermelon in one sitting.

There is all that and more in you, too, if you take the time to look for it.

To follow along with my everyday life with trichotillomania and a dose of positive productivity, find me on Instagram.

Save this hair idea

Enter your email to get this picture to your inbox, and get other ideas you might like 💌

Save image form