The clinical diagnosis can be supported by making a “hair growth window” by shaving a small area of involved scalp (at least weekly) to demonstrate normal dense hair regrowth.
Trichotillomania (TTM) is considered an impulse disorder in which there is self-induced plucking or breakage of hair resulting in noticeable hair loss.
There is a wide clinical spectrum and not all patients with TTM meet the DSM-IV diagnostic criteria.
The highest incidence of TTM is in childhood and adolescence and is most commonly seen in girls of age 5 to 12 years.
Bizarre shapes with irregular or telltale geometric shapes (Fig. 9.7) or borders can be seen; some start at a single point and go out centrifugally in a wave-like manner.
Typically, hairs in occiput are spared; occasionally the whole scalp is involved.
Patients with TTM pluck scalp hair most frequently but they may also pluck hair from other hair-bearing areas of the body such as eyebrows.
The clinical diagnosis can be supported by making a “hair growth window” by shaving a small area of involved scalp (at least weekly) to demonstrate normal dense hair regrowth.
Management