Trichotillomania in adults

The cause of hair plucking is purely psychological. The extent of the hair plucking and the area from which the hair is plucked seem to have no direct correlation with the patient's underlying psychopathologic behavior. Hair plucking that begins in childhood and extends into adolescence and adulthood may represent a more complex psychopathologic condition. Therapy can consist of confronting the patient with his behavior and helping him cope with the triggering stressful external causes. Psychiatric consultation is suggested if this is not helpful. Trichotillomania by definition implies psychosis. Since this behavior is seldom associated with psychosis, we suggest the term hair plucking be used to describe this syndrome. Herein, we present two cases of trichotillomania (hair plucking), review of the relevant literature dealing with the psychopathologic nature of this disorder, and suggest methods for managing these patients.