Trichotillomania: disease causes people to pluck out the hair …

At the end of last year, the news of a 19-year-old British girl who underwent an eyelash implant drew attention.

The procedure was only necessary because Louise Thomas has been in the habit of tearing the strings and hairs from her body since the age of two-until they stopped being born on her eyelids.
Louise suffers from an impulse control disorder known as trichotillomania (in Greek, “thrix” means hair and “tillein”, to boot). Little understood, it affects 3% of the world population. Most people believe it to be a simple bad habit, like nail gnawing, which depends only on will power to be cut off from the routine. It is not.
The American Psychiatric Association places the disorder in the same category as kleptomania (habit of stealing), pathological gambling (gambling addiction) and pyromania (burning objects and places). And there are still experts who classify the hair-pulling craze as a form of OCD (obsessive-compulsive disorder).

It is not yet well understood why the disorder occurs-it is believed in a multifactorial cause, ranging from genetic inheritance to psychological trauma. Usually around 12 years of age, the person has an uncontrollable desire to move and then pull wounds from the scalp (in 80% of cases), as well as eyebrows, eyelashes, and arms, legs and pubic hair.
“It acts as a way of relieving tension. It is recurrent and follows a ritual (always when the person goes to sleep or is alone, for example), can last for hours, results in perceptible hair loss and does not cause pain, but pleasure and Relief, followed by guilt, “explains psychologist Edson Luiz de Toledo, coordinator of the Care for Tricotylomania Carriers of Proamiti (Integrated Ambulatory Program of Impulse Disorders), Institute of Psychiatry, Hospital das Clínicas de São Paulo.

Many patients report feeling ashamed and even take extreme measures, such as leaving home or shaving all hair and wearing wigs or appliques to avoid temptation.
This was the case with law student Queila Ferreira, 22. After the separation of her parents at the age of nine, and living with an aunt who also had the habit of tearing the strands of hair, she began to use the habit as Discounting the anguish and sadness he felt at the time.
As other patients report, until she was 18, Queila wore a cap, fled from social events and family gatherings, collected complexes, and became increasingly introspective. “I was sitting in the back of the classroom and I suffered a lot when a colleague, looking at the flaws in my hair, asked if I had cancer,” she says.

But there are worse cases. The disorder, which affects only one man in ten women, can have serious consequences for individuals who, in addition to tearing, also ingest the wires. The condition can progress to Rapunzel’s syndrome, when a capillary cake is formed that occupies the entire extension of the stomach and can only be removed surgically. Otherwise, it can cause nausea, vomiting, anemia, anorexia and even gastric perforation.
At the first signs of trichotillomania, a specialist should be sought. The recommendation is to turn to the psychiatrist, since in almost all cases there is some other disorder involved. Anxiety disorders and depression usually accompany the hair pulling mania, as well as OCD.

As for treatment, there is still no specific drug. “We use the same medication administered in patients with OCD, in addition to other drugs with recognized action in the control of impulsivity,” says José Alberto Del Porto, professor of psychiatry at the Federal University of São Paulo.
It is also important to associate psychotherapeutic follow-up. According to Toledo, the exercises proposed by cognitive-behavioral therapy help the patient to develop new strategies to deal with the situation.

Source: Folha de S.Paulo (03/18/2010)