Trichotillomania

Trichotillomania (hair pulling) can have a significant impact on your quality of life. It can also cause further medical problems.

Quality of life

Trichotillomania can be distressing for those with the condition because it can cause feelings of:

• guilt
• shame
• isolation (feeling alone)
• embarrassment

This can affect your social life for example,you may have fewer friends or you may find intimate relationships difficult.

Trichotillomania may also affect how well you perform at school or work. For example, you may end up missing school because you're too embarrassed to go in, oryou may find it difficult to concentrate at work, which could affect your career progression.

Some people also feel angry or frustrated about being unable to control their urges, and may use alcohol , smoking or drugs as a way ofcoping.

Alopecia

Telogen effluvium is loss of hair. People with trichotillomania end up losing their hair because they pull it out.

This can cause bald patches or, in some cases, total baldness, which can affect your confidence and self-esteem.

You may avoid certain activities where the bald patches could be noticed, such as going to the hairdresser or going swimming.

Trichobezoars

Trichobezoars are hair balls that can form in your stomach or bowel if you eat the hair you pull out. The hair balls can cause serious symptoms such as:

• blocking, or making a hole in,your digestive system
• acute pancreatitis painful inflammation of your pancreas
• obstructive jaundice where the hair ball blocks tubes that remove bile (a fluid that helps digest food), causing a build-up of a yellow substance called bilirubin, resulting in a yellowing of theskin andwhites of the eyes

In severe cases, stomach or intestinal surgery may be needed to remove the hair ball.