Trichotillomania

Compassionate Care & When Hair Transplant Is an Option

20 Years of Expertise : Every Step Performed in Hong Kong By Doctors

What Is Trichotillomania?

A treatable mental health condition where a person feels an irresistible urge to pull out their own hair.

  • Not a “bad habit” or weakness: Classified as an obsessive-compulsive related disorder.

  • Affects 1-2% of people: Often starts in childhood/adolescence.

  • Cycle of tension & relief: Urge builds, pulling happens, followed by temporary calm.

  • Important: This is not your fault. Recovery is possible with the right support.

Sara’s Comment

Can hair transplant treat trichotillomania?
Almost never during active pulling. Surgery is a last resort, only considered after long-term behavioral stability.

🔍 Seeking clarity on your hair loss?
If you are struggling with hair pulling, we strongly recommend consulting a mental health professional first. If you have been pull-free for years and wish to explore surgical restoration, we can provide a careful, no-obligation assessment.

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How to Recognize Trichotillomania

Unlike other hair loss, trich leaves distinct signs:

  • Patchy, irregular bald spots with straight or geometric edges.

  • Hairs of many lengths in one area (new growth repeatedly pulled).

  • Broken hairs, coiled strands, or dark stubs close to the scalp.

  • Preserved follicles (no scarring), meaning hair can regrow if pulling stops.

Common Pattern: Hair loss in areas easily reached by your dominant hand (e.g., a “Friar Tuck” bald crown with sides intact).

The "No Regret" Treatment Path: Behavior First

Gold Standard Treatment: Behavioral Therapy

  • Habit Reversal Training (HRT): Learn to recognize urges and replace pulling with a harmless action.

  • Comprehensive Behavioral Therapy (ComB): Adds mindfulness, environmental changes, and emotional skills.

  • Recovery is about progress, not perfection. Self-compassion is key.

Supportive Medical Treatment

  • N-Acetylcysteine (NAC): An over-the-counter supplement with clinical support for reducing urges.

  • Medication (SSRIs, etc.): May help if anxiety or depression co-exists, but therapy is essential.

Hair Transplant: Extreme Caution Required

Transplanting during active trichotillomania typically leads to failure and greater emotional distress. The urge to pull will not distinguish between native and transplanted hairs.

Surgery is strongly contraindicated if:

  • You have pulled hair in the past year.

  • You have not completed behavioral therapy.

  • A mental health provider has not cleared you.

Surgery might be considered only after:

  1. 12–24 months of zero pulling, verified by self-report and a support person.

  2. Completion of successful behavioral therapy.

  3. Written support from your therapist or psychiatrist.

  4. Realistic understanding that relapse could destroy the grafts.

Even then, risks remain high. Post-operative itching or stress can reactivate the urge.

Key Takeaways : Healing From Within

Hair transplant is not a treatment for trichotillomania. Lasting recovery begins with behavioral and psychological support.

Our role as surgeons is to protect you from a costly, invasive procedure that is almost certain to fail if the underlying compulsion is not resolved first.

If you have achieved long-term stability and have permanent bald patches, a transplant may be an option to restore what was lost—but the foundation must be solid.

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MEDICAL - DISCLAIMERS

Images & Information shown are for reference only

Information on this website is provided for general educational purposes only and does not constitute personalized medical advice. It is not intended to promote our service or imply superiority over another.

Individual results in hair restoration vary significantly and no outcome can be guaranteed. The before-and-after images shown represent possible results — not promises. We recommend seeking independent medical advice to discuss your options … Read More

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Still Have Questions ?

If you want to get a personalized answer from our medical team, you can reach us using this form here. We will cantact you as soon as possible.

Our ‘No Regret’ Safety & Precision Protocol

At Dr. Bertram Hair Transplant, we only offer what aligns with natural results, minimal risk, and realistic expectations. Since 2009, our FUE protocols are in strict accordance with evidence-based guidelines from ISHRS and WFI. Every procedure is internally audited against ABHRS surgical benchmarks,

ISHRS

International Society of Hair Restoration Surgery is the leading global medical association that establishes international practice standards and patient safety protocols.

ABHRS

The American Board of Hair restoration Surgery represents the highest standard. To maintain rigorous certification requirements the physician must demonstrate surgical expertise.

WFI

Worls FUE InstituteI serves as the premier educational body focused exclusively on Follicular Unit Extraction methodology. The institute ensures consistent application of safe FUE.

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