[Diagnosis and treatment of hair pulling- and skin picking disorder]

Hair pulling disorder (HPD; trichotillomania) is characterized by recurrent pulling of hair from the scalp, eyebrows or other parts of the body. Skin picking disorder (SPD) is closely related to HPD and involves re-current picking of the skin. Even though both HPD and SPD are relatively common and potentially severe disorders, health professionals typically know little about them. In the present article, we describe the clinical characteristics of these problems and provide diagnostic guidelines. We also discuss main treatment approaches (drug treatments and behavior therapy) and review research on their efficacy. Results show that behavior therapy (habit reversal) has consistently been shown to be effective, SSRIs seem not to work, but preliminary data suggest that other drugs (e.g. N-acetylcysteine) may benefit some patients.