Treatment & Services

What is Trichotillomania? Information about how the disorder is diagnosed and facts about who has it and how widespread the disorder is.

What is Trichotillomania?

The current diagnostic criteria include:

  • Recurrent pulling out of one's hair, resulting in hair loss.
  • Repeated attempts to decrease or stop hair pulling.
  • The hair pulling causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • The hair pulling or hair loss is not attributable to another medical condition (e.g., a dermatological condition).
  • The hair pulling is not better explained by the symptoms of another mental disorder (e.g., attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder).

Demographics of Trichotillomania

  • TTM is estimated to have a 1-3% prevalence in the general population
  • Research and clinical experience indicate that trichotillomania affects more women than men. Studies estimate that over 90% of people with trichotillomania are female. The female predominance could be overstated, however, since men are less likely to seek psychological treatment. Furthermore, men are more able to hide their baldness or to explain it as a natural part of aging
  • The mean age of onset is in early adolescence (11-13 years of age) though children as young as 1 year of age with TTM have been reported in the literature

What is Excoriation Disorder?

A new category for skin picking, Excoriation (Skin-Picking) Disorder was included as a separate diagnostic category for the first time ever in DSM-5.

The current diagnostic criteria include:

  • Recurrent skin picking resulting in skin lesions
  • Repeated attempts to decrease or stop skin picking
  • Clinically significant distress or impairment in social, occupational, or important areas of functioning as a result of skin picking
  • Picking cannot be due to the physiological effects of substances such as cocaine or medical conditions such as scabies
  • Picking cannot be better explained by another mental disorder (e.g. tactile hallucinations in a psychotic disorder, fixing a perceived appearance defect in body dysmorphic disorder, harming oneself in non-suicidal self-injury)

Demographics of Excoriation Disorder

  • Studies have found that 1.4-5.4% of U.S. adults have clinical skin picking and over 75% of them are female.
  • The disorder has a tri-modal age of onset: before age 10, adolescence or young adulthood (ages 15-21), and between ages 30-45, though childhood or adolescent onset is most common.