Trichotillomania (hair pulling disorder), is an obsessive-compulsive spectrum disorder characterized by a long term, irresistible urge to pull out one's hair. This occurs to the degree that significant hair loss can be seen.


Prevalence is 1-2% in the general population. It affects significantly more females than males. There is a high comorbidity with OCD, excoriation disorder, body dysmorphia, and tics.

Criterion A
Criterion B
Criterion C
Criterion D
Criterion E
Criterion F


Specify if:

Severity Specifier

Specify if:

  • Massachusetts General Hospital (MGH) Hairpulling Scale (A 7-item self-report)
  • Psychiatric Institute Trichotillomania Scale (6-item clinician rated)
  • NIMH Trichotillomania Severity/Impairment Scale

Except for clomipramine, which has shown some proven benefit in studies, SSRIs/SNRIs are generally ineffective for trichotillomania. Alternatively, antipsychotics such as those described above, may be beneficial as primary medications. Studies have also shown promising results for N-acetylcysteine and naltrexone. The main treatment for this condition is a specific type of CBT called habit reversal training.