The treatment of trichotillomania is based on a multidisciplinary approach. In turn, the behavior is part of Chronic OCD and is thought to be largely related to anxiety disorders.
Obsessive-compulsive disorders comprise much of the clinical presentations revolving around the central theme of repetitive thoughts and activities that are performed in the same way. Under this particular spectrum, is trichotillomania, also known as hair pulling disorder.
Hair is repeatedly plucked from anywhere on the body and simulates loss, such as alopecia. In any case, it is caused by the action of the person, unlike pathologies that originate in processes of another nature.
What is trichotillomania?
Trichotillomania is a psychiatric condition, often debilitating, characterized by recurring hair pulling. Thus, this leads to hair loss with marked functional deterioration of the skin plates due to constant exposure to aggressions.
Many patients with this disorder report that a stressful situation had occurred before the behavior began. Starting in adolescence, relationships that lifetime prevalence reaches 3.5%. This means that more than 3 out of 100 people worldwide suffer from it.
The trouble is notification more frequently in women and the ratio is about 9:1 than in men. Clearly, it turns out to have a female profile.
Characteristics of the disorder
Generally, the hands are used to pull the hair, but tweezers or other devices can be used. The hair on the head is the most common to pluck, although it can be anywhere on the body. After pulling, some people will inspect it and eat all or part of the fanera.
It is important to bear in mind that hair pulling occurs automatically when the patient is unconscious or does not concentrate. Some people have the friar tuck signwith hair loss in an area other than the crown of the head and maintenance in the temporal and occipital regions of the skull.
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Treatment of trichotillomania
Trichotillomania is a disorder multifaceted which often involves several cross-medical specialties, as well as multiple treatment modalities. The patient can be seen by a general practitioner, a dermatologist, a psychiatrist and a psychologist. Treatment usually includes therapeutic techniques and the use of medications.
Therapeutic techniques being studied for the treatment of trichotillomania include therapy cognitive-behavioral and habit reversal training.
Habit reversal therapy has three components: mindfulness, response literacy, and social support.. The person is trained to be aware of hair pulling and the situations or emotions that cause the action to repeat. That way, they’ll be able to tell when they’re in the middle of the act and if they’re about to perform the behavior.
In response, they are praised for their correct knowledge and reminded if they are incorrect. Once that solidifies, they are sign a competitive response that is an action taken instead of hair pulling. They have to complete this task when they feel like completing the task.
Social support from those around the person is essential to habit reversal training. They should praise appropriate use of training or remind the patient to use it when they don’t.
On the other hand, behavioral therapy, while effective, is not without its limitations. One of the more well-known problems is the recurrence rate after the treatment.
Read also: Eyebrow and eyelash alopecia: which treatment can I follow?
Drug treatment for trichotillomania
There is preliminary data which have shown some positive effect with olanzapine, aripiprazole and quetiapine. Olanzapine has been associated with metabolic syndrome, so the decision to use it as a treatment should be moderated by its adverse side effect profile.
Others Education Dermatology Brazilian Anais report new treatments using N-acetylcysteine. This substance has shown positive results and it is one of the most influential drugs in the perspectives of the new approach, given the first results on its efficacy and safety.
Clomipramine, a tricyclic antidepressant with serotonergic properties, appears to be effective. However, its unfavorable side effect profile makes it a second-line treatment.
Treatment of trichotillomania is complex and long-term
If left untreated, trichotillomania is a chronic disease that often causes significant psychosocial dysfunction. Also, in rare cases, it can lead to associated medical problems that further complicate the situation of the person suffering from it.
The prognosis is better if diagnosed early.. This is sometimes difficult because patients don’t want to consult and even hide the habit from their closest beings. It may end up being the job of the relatives to determine the degree of vigilance to bring to the consultation.
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