Community Empowerment and Mentality as a Treatment in Treatment-Resistant Trichotillomania: A Case Report

Trichotillomania, a psycho-dermatologic disorder defined by self-inflicted often noticeable hair loss through hair-pulling, is difficult to manage and treat. Its etiology is multifactorial and frequently is complicated by comorbid conditions like anxiety and depression. Evidence-based treatment is limited but options involve a combination of pharmacotherapy and cognitive-behavioral therapy (CBT), habit reversal training (HRT), and acceptance and commitment therapy (ACT). Many individuals still struggle with the condition despite therapy efforts. This is the case of a 24-year-old female who has a diagnosis of treatment-resistant trichotillomania and found remission of hair-pulling and subsequent hair regrowth by a combination of mindset reframing, physical barriers, and community support. Through these mechanisms, she has managed to stay pull-free for 9 months, the longest period she has experienced without hair-pulling episodes in 10 years. This case demonstrates that novel approaches using enhanced mindsets and shared experiences can provide positive results for people affected by trichotillomania. The implications of this case may help other individuals suffering from this diagnosis achieve remission of hair-pulling. Additionally, this case serves as a catalyst for future research to be done into the long-term effects of community empowerment and mentality-based interventions as treatments for trichotillomania.