Trichotillomania (TTM) or "trich" is an impulse control disorder characterised by the repeated urge to pull out scalp hair, eyelashes, beard hair, nose hair, pubic hair, eyebrows or other body hair. It may be distantly related to obsessive-compulsive disorder, with which it shares both similarities and differences. Trichotillomania has been mentioned as a disorder in very early historical records. Onset generally occurs at puberty. There is a strong stress-related component, that is, in low-stress environments some stop pulling altogether. Pulling resumes when one leaves this environment. 80% of those afflicted are female {^*}. Evidence is now starting to accumulate pointing to TTM as being genetic in origin.

Most TTM sufferers live relatively normal lives, except for having bald spots on their head, among their eyelashes, or brows. Eyelashes have been reported to grow back thinner or in much lesser amounts. An additional danger is from the low self-esteem which comes from being shunned by peers, and the fear of socializing due to appearance. Many clinicians classify TTM as a mental disorder, though the classification is debatable. Some clinicians classify TTM as a form of obsessive-compulsive disorder. Some classify TTM as a form of self-harm. Some say it is neurobiological condition. Others say that TTM is no more a mental disorder than is any other habitual behavior, such as nail biting (onychophagia) or compulsive skin picking (dermatotillomania), while others say that it is a type of addiction. Many TTM sufferers have relatively normal work and social lives; and TTM sufferers are not any more likely to have significant personality disorders than anyone else.

While there is no cure, there are some treatments. There have been a few small and not well-controlled clinical trials of drug treatment for trichotillomania, for example using such drugs as anafranil, prozac, and lithium. No one medication has been shown to have a particular advantage over any other, and drugs alone have not been shown to be particularly effective for many people. One should use care in choosing a therapist who has specific training, experience, and insight into the condition, lest one be overdiagnosed or overmedicated. Prozac and other similar drugs, which some professionals prescribe on a one-size-fits-all basis, tend to have limited usefulness in treating TTM, and can often have significant side effects.

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