It may begin during a quiet moment on the couch. One hand drifts toward the scalp, fingers searching for a particular strand, and the hair is pulled out before the person fully realizes what is happening. At other times, the action is deliberate, following an urge that feels increasingly difficult to ignore.
This is life with trichotillomania, a mental health condition that can cause visible hair loss, physical injury, and intense feelings of shame. Although hair pulling is commonly associated with anxiety or emotional distress, new research published in Comprehensive Psychiatry suggests another set of everyday experiences — particularly boredom and tiredness — may play an important role.
What Is Trichotillomania?
Trichotillomania is characterized by recurring urges to pull hair from the scalp, eyebrows, eyelashes, or other areas of the body. According to the Mayo Clinic, it belongs to a category called body-focused repetitive behaviors, which also include actions such as skin picking, nail biting, and lip chewing.
Some people engage in focused pulling, consciously selecting and removing hairs to relieve an uncomfortable sensation or internal pressure. Others pull automatically while watching television, reading, or completing other activities. An episode may last only seconds or continue for hours.
According to Harvard Health Publishing, the condition affects about 1 in every 50-100 people. Despite that prevalence, it is often misunderstood or hidden. Patchy hair loss may be disguised with makeup, hats, wigs, or hairstyles, while the behavior itself commonly occurs in private.
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Why Do People Pull Their Hair, and Why Can It Be Harmful?
Hair pulling can produce satisfaction, stimulation, or temporary relief, reinforcing the behavior and making the cycle difficult to interrupt. Stress, frustration, loneliness, fatigue, and boredom may all contribute, but triggers can differ between individuals.
Harvard Health Publishing notes that, over time, repeated pulling can damage hair follicles and cause skin wounds, scarring, or infections. The repetitive hand movements may even contribute to problems such as carpal tunnel syndrome. The emotional consequences can be just as serious. People may avoid relationships, school, work, or social activities because they feel embarrassed about their hair loss or unable to control the behavior.
Treatment often includes cognitive behavioral therapy. One common approach, habit-reversal training, helps people recognize their triggers and substitute another action when the urge appears. Medication may also help some individuals, although no single treatment works for everyone.
Boredom and Tiredness May Help Drive Hair Pulling
For the new study, researchers followed 61 adults diagnosed with trichotillomania for 10 days. Participants received seven smartphone surveys each day asking about their emotions, tiredness, boredom, urge intensity, and recent hair pulling. This real-time method reduced the need to reconstruct experiences from memory.
A strong urge was the clearest predictor of a later pulling episode, while previous episodes raised the likelihood of pulling again. Surprisingly, boredom was the only emotional state that predicted subsequent hair pulling. Tiredness predicted a stronger future urge, while negative emotions such as anxiety or sadness did not reliably forecast later episodes.
The findings of this recent study suggest trichotillomania treatment could benefit from looking beyond stress and paying closer attention to fatigue, boredom, routines, and environments — the ordinary moments in which an urge can become a damaging action.
This article is not offering medical advice and should be used for informational purposes only.
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Article Sources
Our writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:
- This article references information from the Mayo Clinic: Trichotillomania (hair-pulling disorder)
- This article references information from Harvard Health Publishing: A hair-pulling disorder
- This article references information from a study published in Comprehensive Psychiatry: Trichotillomania: The interplay between emotional states, urges and hair pulling episodes
