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The who, what, where, when, why and how of picking, pulling and biting behaviors
Published in Stacy K. Nakell, Treatment for Body-Focused Repetitive Behaviors, 2023
Physically, hair pulling is a sensory experience that involves pulling hair out of the scalp, lashes, brows or other areas with the fingers or tweezers. The behavior usually involves a pre-pulling ritual of searching for hairs with the desirable texture and characteristics, like gray, kinky or short. It is usually followed by a post-pulling ritual of manipulating the hair in some way, like running it through the fingers, pulling or biting off the hair bulb and feeling it, touching it to the lips or crunching it between the teeth, or chewing and swallowing the hair itself. Hair swallowing is also known as trichophagia and can create medical complications. The rituals and behaviors can involve all five senses: touch, taste, smell, sight and sound.
Introduction to Geophagia
Published in Anil Gupta, Geophagia, 2019
TrichophagiaTrichophagia is the compulsive eating of one's own hair. The affected person pulls the hair and eats it (Chamberlain et al. 2007).
Pharmacotherapy for trichotillomania in adults
Published in Expert Opinion on Pharmacotherapy, 2020
Christine Baczynski, Verinder Sharma
When left untreated, TTM can have a detrimental effect on an individual’s mental and physical wellbeing. A study by Stemberger et al. found that over 70% of the patients reported significant feelings of shame, irritability, and low self-esteem related to their hair pulling [35]. Over 80% of patients in the same study reported feeling depressed or unattractive because of their illness. Other studies have shown that patients report several impairments in the areas of social and occupational functioning, such as decreased quality of interpersonal relationships and interference with daily job duties [1,10,35]. Trichotillomania can also have negative physical consequences, such as inflammation of hair follicles and surrounding skin and complications that arise from trichophagia [31] (eating the hair that has been pulled) in some patients, such as gastrointestinal issues and development of a dangerous and potentially life-threatening blockage in the intestinal tract known as a trichobezoar [36].
Review of epidemiology, clinical presentation, diagnosis, and treatment of common primary psychiatric causes of cutaneous disease
Published in Journal of Dermatological Treatment, 2018
J. A. Krooks, A. G. Weatherall, P. J. Holland
Patients with TTM recurrently pull out their hair, resulting in prominent hair loss and significant distress and/or functional impairment (95). The median time spent engaging in behavior is 45 min/day (range 15–240 min) (96). Patients predominantly pull hair from the scalp (83%) (97). Other regions implicated include eyelashes, eyebrows, and pubic, face, and body hair (98). Trichophagia (swallowing hair after pulling it out) is observed in over 20% of patients and may result in a life-threatening trichobezoar (hairball) that may block the intestine and require emergency surgery (99). Patients may present with abdominal or chest pain, change in bowels, unexplained weight loss, and/or vomiting. Abdominal CT scan is diagnostic in 97% of cases (95). Typical age at onset is 10–13 years. There is a 4:1 adult women: male prevalence and an equal gender distribution in children (95). Prior studies have reported a prevalence of 0.6%; however, the prevalence is likely higher considering patients’ reluctance to reveal behavior and updated, less stringent diagnostic criteria (95).
Trichobezoar presenting as an acute abdominal obstruction in a 17-year-old girl
Published in Paediatrics and International Child Health, 2022
Zuhal Bayramoglu, Rana Gunoz Comert, Basak Erginel, Abdulkadir Baziki
Trichobezoars generally occur in females with long hair. Cases in males are associated with ingesting the hair of female relatives [3]. The vast majority of trichobezoars are diagnosed in adolescence and in the second decade. The cause of this uncommon entity is attributed to psychiatric disorders such as trichotillomania (pulling out one’s hair) and trichophagia (eating hair) [2]. In most patients with trichophagia, a bezoar is not formed, but in 1% of patients it is [4].