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Trichotillomania: Getting to the “Root” of This Disturbing Affliction

Updated on November 23, 2011

Trichotillomania is hair loss from repeated urges to pull or twist the hair until it breaks off. I would know…I have a slight form of it. To me, it’s just as common as someone who bites his or her fingernails, but to others, it is seen as something much more disturbing.

I have been twisting and tying knots in my hair for as long as I can remember. I remember growing up and my daddy would tell me to stop. Most times I wasn’t even aware that I was doing it. In college, it became a party trick. Watch me tie multiple knots in my hair with one hand and then watch me take them out, all with relative ease. It’s the times that I can’t wiggle a knot out that the disease rears its ugly head. What do I do when I can’t release the knot? Yep, that’s right…I break it off.

Luck has it for me that I have a very thick, headful of hair. I am always able to cover my nasty habit because I always pulled from underneath my think tresses. My hairdresser comments that she can tell when I’ve been “picking” as she calls it. She even sees bald spots in moderation on my scalp.

I find that I never do this in public; I save it for the privacy of my own home. My husband HATES it. When we were moving me out of an apartment while we were only dating, we moved the sectional couch and found hundreds upon hundreds of blonde knots on the ground where I had stuffed them between couch cushions. I remember my husband giving me an ultimatum once that I couldn’t twist and break off my hair anymore. My solution: a pixie haircut. It was the only way that I knew I wouldn’t do it anymore.

Research says depression and stress most often increase the need to pull at the hair. Where I have never been truly depressed, I am often stressed-out. It also adds that it’s an overwhelming urge to participate in this behavior. I know this for a fact.

I am currently doing it so often and so badly that I know that it will start making a difference on my hair’s appearance, but it’s like a drug to me. When I am not twisting my hair, I’m thinking about doing it no matter how badly I want to stop.

Specialists in this biological brain condition recommend Cognitive Behavioral Therapy and sometimes medications to relieve the urges to twist, pull, and pick. I rely putting a bandana around my head so that I can’t get to my hair. Sometimes it works; sometimes it doesn’t.

I once knew a young lady who was almost completely bald except for the hair at the base of her head. I always wanted to ask her if she had the affliction. After months of seeing her, I asked. She affirmed what I had feared. It scared me for a while into thinking that I could end up being almost bald like her. Clearly it didn’t scare me enough.

As for the root of my trichotillomania, I may never know if I just lost out on the hair lottery in gestation or it was hereditary as some say. Either way, I’ll be walking around my house looking like I need to be on the back of someone’s Harley with my bandana protecting the precious hair that hangs on for dear life.

To read more about trichotillomania, visit


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      Michele 2 years ago

      I have been doing this since I was 18. It puts me in a trance like state and the feeling of the hair and knots through my fingers relieves stress, but like all bad habits I then feel bad about my behavior and obsess over the damage to my hair.

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      Sara 3 years ago

      I thought I was the only one to tie knots. All the case studies I've seen the person pulls out full strands or bunches at once. I find thin strands of hair and tie small knots. at the tips If I can't get them to release, I break the tip off. I do it the most when I'm stressed out or watching tv. I don't have the urge in public or around new people. I don't have bald spots, but my hairstylists comments about how frayed the tips of my end are when I just had it trimmed a month ago. I've been doing this since I was six or seven and figured out I could tie knots in my hair. I also had a problem with nail biting. Started around age 3. I have managed to break myself of that though. The only time I stop with my hair is if it only comes to my ear lobe in length. Then it's not long enough for me to look at properly and pick out strands.

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      rachael 4 years ago

      I do the exactly same thing! im actually doing it right now as i type its so fustrating, i urge to knot my hair. I don't know weather mine is compulsive or not but i have to knot a thin strand of my hair until it gets about halfway up and then i rip it out and knot it in my hands until it's a big knot. Its very embarrasing and i know im ruining my hair i just can't seem to stop doing it

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      4 years ago

      I do the same thing. I have done it ever since I was little. I take a small bunch of hair and twirl it and if its gets knotted...well i mean i have to pull it out. It isn't really ever the whole bunch, just the part at the bottom that got knotted. Luckily I have curly hair and a little messiness looks good....but it still worries me.