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Essay Looks at History of Hair-Pulling Disorder Trichotillomania

‘On Trichotillomania and Its Hairy History’ is an essay by Whan B. Kim, BSc from the Michael G. DeGroote School of Medicine, McMaster University in Ontario, Canada. Published in the JAMA Dermatology medical journal, it reflects upon the historical and cultural references of hair loss from the compulsive act of hair pulling.

Hippocrates - The Founder of Western Medicine and the first to identify Alopecia Areata and TrichotillomaniaDiscovered by Hippocrates

According to Kim’s research, the earliest reported mention of trichotillomania in medical literature was made by Hippocrates, the founder of modern medicine. Hippocrates is also credited with being the first to identify Alopecia Areata, the autoimmune condition which causes patchy hair loss.

According to the essay, In Epidermis III, Hippocrates describes the wife of Selearces, who at the height of grief and depression, “groped about, scratching and plucking out hair”. This phenomenon must have made quite an impression on Hippocrates, such that he included hair pulling as part of his routine assessment of patients’.

Despite this early start, Kim explains that the condition did not receive the name ‘trichotillomania’ until the late 18th century when the term was coined by French dermatologist, Hallopeau Francois Henri. We now use this term to reference the obsessive behavioural disorder which causes those affected to pull or twist out their hair due to stress or anxiety.

Romeo and Juliet: Romeo References Hair Pulling in the Shakespeare ClassicCultural references

Mentions of this disorder are not limited to the medical sphere; references can be found in classic literature too – from the Bible to Shakespeare’s Romeo and Juliet.

Kim references ‘the words of the prophet Ezra appalled at Israel’s unfaithfulness (“And when I heard this thing, I… plucked off the hair of my head and of my beard…”); the Greek king Agammemnon grieving on the Trojan plains (“…but whensoever to the ships he glanced and to the host of the Achaians, then rent he many a lock clean forth from his head…”); and the tragic Romeo in defence of his infatuation with Juliet (“Wert thou as young as I… then mightst thou speak, then mightst thou tear they hair…”)’.

Coping with trichotillomania

Although the essay notes ‘we may be paying homage to this act of hair pulling in our everyday life when we tug at our hair in frustration’, trichotillomania is very different. Far from an occasional, exasperated root tug, people with trichotillomania are compelled to pull or twist their hair until it comes out. This can lead to hair breakage and bald patches.

Trichotillomania - a compulsion to pull or twist out your own hairJoanna Goldberg recently wrote in Good Housekeeping about her experience of this behavioural disorder which left her bald by the age of 15.

The first hair pull was the most relieving sensation… My index finger and thumb would zero in on a singular hair, twirl it, stretch it taught, then pluck it right out. I’d examine the root and feel momentarily satisfied, even relaxed, but as immediately as the rush of calm came over me, the overwhelming tension returned, peppered liberally with shame,” she said.

This cycle of tension — pulling, then relief, then pulling again — would repeat over and over until I was unrecognizable… eventually, single hairs add up, parts widen, and bald patches connect. No one seemed to notice until the unappealing effects escalated enough to be an undeniable problem.”

Comparing the compulsion to nail-biting rather than self-harm, despite it being fairly painful, Goldberg explained that it is a form of mental illness which needs to be treated as such. She recovered thanks to “a combination of meditation, medication, therapy, time, and not having any hair left to yank out by the root“.

We do not treat trichotillomania here at Belgravia but if you are concerned about compulsive hair-pulling it is best to seek medical advice from your doctor. Once you are successfully in recovery, hair growth boosters may help you to regrow your hair if the follicles have not scarred over, but addressing the underlying cause of the behaviour is the most important step.


The Belgravia CentreThe Belgravia Centre

The Belgravia Centre is the leader in hair loss treatment in the UK, with two clinics based in Central London. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the UK or the rest of the world. View our Hair Loss Success Stories, which are the largest collection of such success stories in the world and demonstrate the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time for our hair loss helpline or to arrange a free consultation.


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