Hair pulling (trichotillomania) and skin picking
बाल खींचना और त्वचा नोचना
Trichotillomania (hair pulling) and excoriation (skin picking) are body-focused repetitive behaviours. They often happen automatically, during stress or boredom, and cause bald patches, wounds and embarrassment.
They are not a bad habit that needs only willpower — specific behavioural therapy works.
Medically reviewed by Dr. Kuldeep Budania, MBBS, MD Psychiatry
Common symptoms
- Repeated pulling of scalp hair, eyebrows or eyelashes
- Repeated picking of skin, acne or nails, causing wounds
- Repeated attempts to stop
- Tension before and relief or pleasure after the behaviour
- Hiding the effects with caps, make-up or long sleeves
Causes
- Brain circuits related to habits and OCD
- Stress, anxiety, boredom and sensory triggers
Risk factors
- Onset in late childhood or adolescence
- OCD, anxiety or depression; family history
How it is diagnosed
- History of the behaviour, triggers and attempts to stop
- Excluding skin or scalp disease with a dermatologist when needed
- Asking about swallowing hair, which can cause stomach problems
Classification: ICD-10 F63.3 · ICD-11 6B25.0, 6B25.1Trichotillomania / excoriation disorder (body-focused repetitive behaviour disorders).
Treatment options
- 1Habit reversal training — the first-line treatment
- 2Treating associated anxiety or depression; medicines in selected cases
- 3Skin care for wounds
Psychotherapy and counselling
- Awareness training: noticing when and where the behaviour happens
- Competing responses (for example, clenching fists) and changing the environment (gloves, fidget toys)
Guidance for family
- Do not scold or slap hands away — it increases shame and tension
- Agree on gentle cues with the person
When to see a psychiatrist
- Visible hair loss or skin wounds
- Avoiding people or activities because of it
Thoughts of self-harm or a medical emergency? Call Tele-MANAS 14416 (24×7, free) or 112.
Free self-assessment
A short screening in Hindi or English. Private — nothing is saved. Screening does not establish a diagnosis.
Frequently asked questions
Is it a type of OCD?
It is in the same family of OCD-related disorders, but the treatment focus is habit reversal.
Will the hair grow back?
In most cases yes, once pulling stops, unless pulling has continued for many years.
Can children be treated?
Yes. Behavioural therapy is adapted for children with parent involvement.
Help is available — confidential, in Hindi or English.
Private video consultation from anywhere in India with an Ajmer-based psychiatrist. Psychiatry consultation ₹500.
This page is for education and does not replace a personal consultation. Do not start or stop any medicine without a doctor's advice.