Cape Town - Have you ever been so frustrated that you want to pull out your hair?
Well, for some people this is not just a saying, but a manifestation of a mental health disorder known as Trichotillomania (TTM) or hair-pulling disorder.
As October is observed as mental health month, Stellenbosch University researchers have warned that while the hair-pulling disorder was once the world best kept secret, the condition was now “coming out of the closet” as more people reported and talked about it.
Characterised by an irresistible urge to pull out hair, usually from the scalp, eye lashes and eyebrows, TTM is a type of impulse control disorder that affects up to four percent of South Africans.
Prof Christine Lochner from the Medical Research (MRC) Unit on Anxiety and Stress Disorders at Stellenbosch University, who has carried out studies on impulsive disorders, said her latest study, which looked at genetic and brain imaging of TTM sufferers, was aimed at learning more about this “secretive” disorder “at a clinical level, but also to see what the neurobiological underpinnings are”.
“We would like to know what causes this condition or what are the associated features, and how does the structure or functions of certain brain areas differ from folk without this condition,” she said.
Once thought to be rare, Lochner said hair-pulling was a very common problem affecting between one and two people out of every 50 South Africans.
The condition was seen mostly in females, starting as early as adolescence. Sufferers started pulling their hair impulsively from their face, arms, legs, beard, genital area and under arms. While the early onset was spontaneous, but for the rest of sufferers, the act of pulling hair was chronic.
Researchers speculated that hair-pulling was caused by a grooming gene gone berserk.
Unlike other impulsive disorders such as self mutilation, where patients tried to injure themselves, hair-pulling often felt pleasurable rather than painful.
“Individuals with hair-pulling disorder are not trying to injure themselves or to purposefully damage their appearance. In fact, they report repeated attempts to decrease or stop hair-pulling. Some cases are quite severe, and in other cases, this condition is barely noticeable,” said Lochner.
Researchers were not sure what triggered this disorder, and a combination of factors such as genetic predisposition and stressful events were suspected as triggers.
In most cases, people with chronic hair-pulling extracted their hair absentmindedly while doing other things such as reading, watching television or being sad and frustrated.
While many times it was done as a pleasurable impulse, Janine Roos, head of the Mental Health Information Centre at Stellenbosch University, said hair-pulling left bald spots on one’s scalp, leaving sufferers ashamed and embarrassed.
“Maintaining one’s dignity when there are bald patches due to pulling is hard. Patients with the disorder experience significant shame about their hair-pulling.
“This may be due to, among other things, a lack of awareness of the disorder. Many patients believe they have a peculiar habit, that they are crazy, or that they are the only people with this problem.
“Low self-esteem is typical and the disorder very often impacts negatively on sufferers’ social lives as hair loss is considered unattractive in women.
“Individuals went to great lengths to avoid situations in which their behaviour or hair loss is exposed.
“Relationships are also often challenging given their shame and avoidance,” she said.
Hair-pullers also resorted to wearing wigs, false eyelashes, scarves, hats, special hairstyles, and make-up to disguise their bald spots.
Cape Argus