Comorbid Conditions Symptom Tests

[Self-Test] Trichotillomania (Hair-Pulling Disorder) Symptoms

Take this self-test to see if you may be exhibiting symptoms of trichotillomania, an underrecognized condition that can affect children and adults.

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Trichotillomania is a type of body-focused repetitive behavior (BFRB) in which individuals repeatedly pull out their own hair, often to the point of noticeable hair loss. (The condition is also known as hair-pulling disorder.) Trichotillomania is thought to affect up to 5% of people, though rates may be higher, as many people with BFRBs do not seek help for their treatable conditions due to shame and stigma.1

While hair pulling is a self-soothing, self-regulating behavior (as is the case for other BFRBs), the results of the behavior often cause significant distress and/or impairment to the individual. People with trichotillomania may consciously or unconsciously engage in hair pulling, which is often done in a ritualistic manner (e.g., searching for a specific kind of hair strand to pull and manually manipulating it once pulled).

Trichotillomania often co-occurs with other BFRBs (like skin picking and lip chewing) and with conditions like depression, anxiety, and attention deficit hyperactivity disorder (ADHD).2 3 Trichotillomania should not be confused for hair removal done for cosmetic reasons or for hair pulling done as a symmetry ritual among some individuals with OCD.

Answer the questions below to see if you may be showing signs of hair-pulling disorder. Share your results with a licensed clinician and/or mental health professional. Regardless of your score, talk to your doctor if you are engaging in hair-pulling and/or other BFRBs, no matter the severity of the behavior(s).

This self-test, drafted by ADDitude editors, is based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This self-test is designed to screen for the possibility of trichotillomania (hair-pulling disorder), and it is intended for personal use only. This self-test is not intended as a diagnostic tool.

I pull out hair from my scalp, eyebrows, eyelids, and/or other parts of my body, which results in hair loss.

Feelings of tension, anxiety, or boredom often precede the hair pulling that I do.

I feel a sense of pleasure or relief when pulling out the hair.

I visually examine the hair that I’ve pulled.

I tactilely and/or orally manipulate the hair that I pull (e.g., roll the hair between fingers, pull the strand between teeth and lips, or swallow the hair).

Sometimes I am not even aware that I am pulling, until it is too late.

I avoid pulling my hair in the presence of others.

I deny my hair-pulling behaviors to others.

My hair pulling/hair loss causes me significant distress.

I avoid work, school, social settings, and other public situations because of my hair pulling/hair loss.

I tell myself that I have to decrease or stop hair pulling.

When I engage in hair-pulling, I find myself searching for a particular kind of hair to pull (e.g., hairs of a certain texture or color).

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Trichotillomania and BFRBs: Next Steps

View Article Sources

1 Madan, S. K., Davidson, J., & Gong, H. (2023). Addressing body-focused repetitive behaviors in the dermatology practice. Clinics in dermatology, S0738-081X(23)00031-7. Advance online publication.

2 American Psychiatric Association. (2013). Trichotillomania. In Diagnostic and statistical manual of mental disorders (5th ed.).

3 Grant, J. E., & Chamberlain, S. R. (2022). Characteristics of 262 adults with skin picking disorder. Comprehensive Psychiatry, 117, 152338. Advance online publication.