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Trichotillomania (TTM) is an impulse control disorder characterized by recurrent pulling out of one's hair, resulting in noticeable hair loss. The most common hair pulling sites include the scalp, eyebrows, and eyelashes, but pulling also occurs frequently on the face, abdomen, legs, arms, armpits, or chest. Early studies of functional impairment in TTM patients suggested that concealing the physical effects of pulling from friends and family, avoiding treatment because of embarrassment, low self-esteem, decreased life satisfaction, and a negative impact on day-to-day living were all common. The TTM diagnostic interview is a standardized clinician interview designed to assess the revised third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria and can be useful. However, further questioning is needed to evaluate the additional criteria described in DSM-IV-TR. Psychotherapy for individuals with TTM typically involves a variety of techniques: habit-reversal training (HRT) and stimulus control training.
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