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Trichotillomania and Substance Abuse

Trichotillomania, or self hair pulling, can be a symptom of substance use or underlying psychiatric disorder. Learn more about the link between trichotillomania and addiction.

Trichotillomaniais a diagnosable psychiatric condition where individuals compulsively pull their head, eyelash or eyebrow hair. Most cases of trichotillomania involve these three areas, and people with trichotillomania feel pleasure or relief from hair pulling. They can also feel significant tension and anxiety when they are unable to pull their hair.

Patients may seek care — often from a doctor or dermatologist — after noticing bald patches or skin disturbances. The symptoms and consequences of trichotillomania can be distressing, although many patients may beunaware of or in denialabout the self-induced hair loss.

Effects of Drug Use on Trichotillomania

Trichotillomania can be a coping strategy for stress and anxiety or an obsessive behavior related to a psychological condition.Researchsuggests that drug use can also increase hair-pulling behaviors, and hair pulling may be a sign of a substance use disorder.

Stimulants and Trichotillomania

People usingstimulantslike cocaine mayexperience tactile hallucinations, like bugs crawling over their arms, as well as heightened anxiety or stress. The effects of stimulants on hair-pulling compulsions can lastfrom hours to days. These feelings may be temporarily alleviated by hair- pulling and often subside once the effect of the drug wears off or a person is no longer using the substance.

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Trichotillomania, Alcohol and Cigarettes

Alcohol has the opposite effect of stimulants and may be used as a coping strategy for feeling on-edge or low.Evidence suggeststhat rather than making hair pulling worse,alcoholis often used to cope with negative feelings related to hair pulling. Since it slows the activity of the nervous system, alcohol may also be used toreduce the urgeto hair-pull. Some people with trichotillomania may alsouse cigarettesto soothe anxiety or obsessions related to the need to hair-pull. While drugs and alcohol may be used as a coping strategy to deal with the discomfort of hair pulling, people with trichotillomania may abuse these substances over time.

Statistics on Trichotillomania and Addiction

Most commonly, mental health problems such asdepressionandanxietyco-occur with trichotillomania. Trichotillomaniahas also been linkedto impulsive behavior and sensation seeking, which are both often present in substance use disorders. Trichotillomania itself has been considered a form of addiction, as those with trichotillomania may experiencewithdrawal or difficulty stoppinghair-pulling behaviors.

Treating Trichotillomania and Co-Occurring Substance Use Disorders

The approach fortreating trichotillomaniadepends on the cause of hair pulling, including underlying mental health conditions or substance use disorders. There is a range of treatment strategies available, including:

  • Medication, such as selective serotonin reuptake inhibitors (SSRIs)
  • Behavioral strategies to bring attention to pulling, like Band-Aids on fingers
  • Developing new stress-management and coping strategies

To discuss treatment for co-occurring trichotillomania and substance abuse,reach outto The Recovery Village today. We will discuss possible treatment plans to get you on the road to recovery.

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Sources

Sah, D. E., et al. “Trichotillomania.” Dermatol Ther, 2008. Accessed April 25, 2019.

Houghton, David C et al. “Comorbidity and quality of life in adults with hair pulling disorder.” Psychiatry research, 2016. Accessed April 25, 2019.

Brewer, Judson A, and Marc N Potenza. “The neurobiology and genetics of impulse control disorders: relationships to drug addictions.” Biochemical pharmacology, 2007. Accessed April 25, 2019.

George, S. and H. Moselhy. “Cocaine-induced trichotillomania.” Addiction, 2005. Accessed April 25, 2019.

Woods, D. W., et al. “The Trichotillomania Impact Project (TIP): exploring phenomenology, functional impairment, and treatment utilization.” J Clin Psychiatry, 2006. Accessed April 25, 2019.

Flessner, C. A., et al. “Styles of pulling in trichotillomania: exploring differences in symptom severity, phenomenology, and functional impact.” Behav Res Ther, 2008. Accessed April 25, 2019.

Brewer, J A, and Potenza, M.N. “The neurobiology and genetics of impulse control disorders: relationships to drug addictions.” Biochemical pharmacology, 2007. Accessed April 25, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.

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