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Sian Confidential: I can’t stop pulling my hair out – literally

Sian provides practical advice to Amelia who is struggling with Trichotillomania

Written by High Life North
Published 27.10.2020

Dear Sian,

This is really embarrassing and stopping me from having relationships. Ever since I was a teenager, I’ve pulled out my hair. It gets worse when I’m stressed.  In the last few years I’ve taken to wearing wigs as the front of my hairline is patchy with couple of actual bald bits; the rest is spiky and tufty. It looks terrible. I’m 28 and have a good job working for a large firm in Newcastle. I’ve looked it up and know it is called Trichotillomania but don’t know how to stop it. Sometimes I do it and can’t remember and other times I do it deliberately knowing I’m going to be so upset after. Why do I do this and how can I stop? I’ve recently been feeling pretty down especially being isolated due to lockdown restrictions. I just overthink all of the time and get myself into a state about it so then end up doing it more!


Dear Amelia,

You are right it does sound like Trichotillomania.  It is also stress related. A lot of nail biting, skin biting or picking and hair pulling, including eyebrows and eyelashes are just sophisticated self-soothing behaviours, similar to why babies and children suck their thumbs. It makes them feel like they are getting their needs met (being fed through teat). It can also be a form of self-harm which if this is the case would be best dealt with by seeking professional help.

There are a number of approaches. Medication such as SSRIs (selective serotonin reuptake inhibitors, also known as antidepressants, but used widely for anxiety) will help manage anxiety that stimulates the bad behaviour and also anxiety about having done it and its effects.

A good alternative route is CBT. I combine CBT with hypnosis for quick results. What often happens when you reduce one self-soothing behaviour another one develops to replace it. To prevent this, I suggest the use of “sweetie bracelets” or beads on elastic. These can be fiddled with and played with instead and don’t have any side effects. This is about breaking the habit, the conditioned behavioural response that is largely unconscious. Crazy sounding techniques do work, like wearing gloves while watching TV, or wearing a bandana while at the computer. You can be as creative as you want. It is very uncomfortable to break any habit and the key is perseverance. Hypnosis and key words implanted in the subconscious also work well for some people, alongside the practical stuff. If you find you are a worrier, and overthinker and suffer from anxiety CBT is a good option as you will also be reducing the thoughts that trigger the anxiety.


*Names are changed to protect anonymity.

About Peaceful Minds


Sian is a cognitive behaviour therapist and also a clinical hypnotherapist, having trained at Goldsmiths College, University of London and the College of Clinical Hypnosis. Four years ago Sian relocated her Harley Street practice to her native North East after 26 years in central London. Sian now runs her private clinic in Gosforth and also owns a training academy to help organisations with stress reduction. Sian’s approach is to help people become their own therapists, whether they come to see her for panic attacks, depression or OCD (she covers a wide range of emotional and behavioural issues).


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