Clinical Pearls for Trichotillomania

  • • Habit Reversal Therapy or n-acetylcysteine (as monotherapies or combined) are the treatments of choice
  • • SSRI not clinically useful for people with stand-alone Trichotillomania
  • • Highly co-morbid with excoriation (Skin Picking) Disorder, OCD, and major depression
  • • Hair pulling symptoms may have origins in dermatologic (alopecia areata) or psychiatric (illicit substance use [meth- amphetamine or cocaine], Body Dysmorphic Disorder) conditions which must be ruled out

Key References

  • • Chamberlain SR, Odlaug BL, Boulougouris V, Fineberg NA, Grant JE. Trichotillomania: neurobiology and treatment. Neurosci Biobehav Rev. 2009 Jun;33(6):831-42.
  • • Hoppe L, Ipser JC, Fineberg N, Chamberlain S, Stein DJ. Pharmacotherapy for trichotillomania. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD007662.
  • • Sarah HM, Hana FZ, Hilary ED, Martin EF. Habit reversal training in trichotillomania: guide for the clinician. Expert Rev Neurother. 2013 Sep;13(9):1069-77.
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