It's not a problem many people talk about. Even among my clients, who know they have a confidential relationship with me, there's much shame and reluctance to admit this behavior.

The problem is called Trichotillomania (trick-oh-till-oh-may-nee-uh). This disorder is closely related to Obsessive Compulsive Disorder (OCD ) and involves pulling out of one’s own hair, eyelashes, or eyebrows. Trichotillomania (or Trich, for short), along with the related disorder termed Excoriation (skin-picking), typically emerge during childhood, are estimated to affect 2 to 4% of the college population, and often continue into adulthood.

Problems that arise from trichotillomania and excoriation include bald patches, loss of eyebrows or eyelashes, and sores. However, more serious conditions can occur, including infections from repeated picking, and digestive issues from consuming hair. The psychological consequences are no less severe – including shame, self-consciousness, and embarrassment. Social isolation often results as the person tries to hide the bald patches or unsightly blemishes.

So why don’t they just stop? What many do not understand is that the urge to pull or pick is experienced as an irresistible compulsion. Making matters more difficult, the actions of pulling or picking have a soothing, relaxing, or even pleasurable quality to those with this disorder. This is what makes the disorder so agonizing to live with and difficult to treat.

However, there is treatment for Trichotillomania. Medication can be helpful. Cognitive Behavioral Therapy teaches patients to develop motivation and use rewards. Patients learn to tolerate the distress associated with resisting urges to pull until resisting becomes easier. Patients also learn to face their social fears and fight their tendency to isolate themselves. While recurrences are not uncommon, most sufferers can gain some control over the disorder, as well as gaining more confidence and decreasing the shame they feel. The Anxiety and Depression Association of America has more on this and other difficulties.