Hair pulling in African Americans--only your hairdresser knows for sure: an exploratory study

The authors examined whether African American hair care professionals saw individuals who met general criteria for trichotillomania, chronic hair pulling that results in significant hair loss. Thirty-eight African American hair care professionals and 1 Caucasian hair care professional were interviewed about their customers' hair-pulling behavior and condition of their hair. Sixteen African American hair care professionals saw 21 individuals who met general criteria for trichotillomania and reportedly perceived the behavior to be problematic. Four African American hair care professionals saw 6 individuals who met general criteria for trichotillomania but did not reportedly perceive the behavior to be problematic. Hair care professionals attributed most customers' hair-pulling behavior to bad nerves, stress, habit, and worry. Hair care professionals appeared adept at treating the consequences of chronic hair pulling but offered little assistance for the actual pulling behavior. Hair care professionals' contact with individuals who engage in chronic hair pulling raises interesting implications for prevention.