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THOUSANDS of Irish people tear their hair out every day but don't seek help because of embarrassment.

It's a secret shame they are scared to share and so they live a life of untold misery and heartache hiding a disorder they have little or no control over.

Trichotillomania, otherwise known as Trich or TTM, is a little-known and less understood condition that is thought to affect as many as 80,000 people, mainly women, in Ireland.

And some estimates put sufferers at 2% of the general population.

It is characterised by an uncontrollable urge to pluck out hair, usually from scalp but also sometimes the eyebrows, eyelashes and even pubic hair, often to the point of baldness.

Sufferers often don't realise they are doing it and are unable to stop them-selves.

For others, like Tracey from Dublin, she went so far as to eat her own hair. And it nearly killed her.

Even more poignant is that she was only five at the time.

Now 31 years later and she is still struggling in her battle against Trich while trying to help her six-year-old daughter who has also been diagnosed with the disorder.

Tracey, 36, told the Irish Daily Mirror: "It started as a child, I didn't even realise what I was doing.

"You do it unknown to yourself, I can't think of anything that could have triggered it off. Even now I do it when I am happy and sad. I still don't know why I get the urge and what causes it."

It was only when Tracey was five and became very ill that the condition was discovered and she had to have emergency surgery to save her life.

She said: "I was getting sick a lot and was in and out of hospital. No one could tell what was wrong. Then I started passing hair from my back passage.

"I had to have surgery to remove a ball of hair from my stomach, my mother was told to kiss me goodbye that she might never see me again, that's how serious it was."

Tracey remembers as a child eating the hair from the heads of her dolls and to this day she still doesn't know or understand why she had this urge.

She added: "They didn't know a lot about the condition in those days, there wasn't much help around."

However, after the operation Tracey stopped pulling her hair but the condition flared up again when she became pregnant at the age of 30 with her second child.

And she was driven to shave her head to try and stop, fearful if she kept tearing her hair out it would never grow back and she'd be bald for life.

Tracey said: "I was pulling hair from my body, my private parts, it was just awful. I actually went down to St Vincent's to sign myself in. Nobody could help me."

However, Tracey was eventually diagnosed with Trich and received support from Leslie Shoemaker, a counselling psychologist who is an advisor to Obsessive Compulsive Disorder Ireland.

Tracey said: "Leslie has been brilliant. The pregnancy may have sparked the condition again I don't know.

"It does upset me, you have no confidence in yourself when you have something like this. I can try and control it now and I don't swallow the hair, it is just something I have to live with and I try and cope as best I can."

Tracey was dealt a terrible blow when she discovered her daughter also suffers from Trich.

But she added: "Because she is being given the help she needs at such a young age she is not too bad.

"Crumlin are brilliant. She has settled down a lot and that is all really down to the psychologist. It's like looking in the mirror when I see her doing it, she eats the hair as well. I make sure she is as active as possible to stop her."

Tracey believes that although the condition is relatively unheard of in Ireland there are thousands like her but they suffer in silence because of the shame or because they don't really understand what is happening.

Psychologist Leslie agrees and said: "People live with the condition in secrecy because they are embarrassed.

"It is one of those disorders that is there, has been there a long time, but no one talks about it.

"In Ireland OCD is the only organisation providing support for this group of sufferers. People don't understand what causes them to pull their hair out, there is so much shame attached to it, it is so sad."

She said that the age of many first-time hair pullers is 12 but there are reports of it affecting people as young as one and as old as 70.

And while there is no cure Leslie emphasises that Trich "is manageable", and that many people with the condition lead active and fulfilling lives.

The two typical forms of treatment are medication and/or Cognitive Behavioural Therapy.

Either of these, or in some cases a combination of the two, focus on the management of the disorder since there is no cure and there is no one proven effective treatment of Trich.

Medication can be quite effective in reducing the urge to pull to a more manageable and less stressful level although in some cases people have reported that medication stopped the urge to pull altogether. Cognitive behavioural therapy is often used with anxiety disorders, depression and OCD as well as with Trich.

The CBT therapist works with the person to identify what may set off the urge to pull as well as to develop new skills to cope with the urges in a different way.

The goal is that by becoming more aware of her triggers, such as stress, emotions or boredom, this will help the person develop new skills to cope with the Trich more effectively.

The type of CBT that is used is called Habit Reversal Training.

Leslie added: "Research into the causes and treatments is still in the early stages but frequently a stressful event can be associated with the onset, such as change of school or job, moving house, family conflict or the death of a parent.

"Symptoms may also be triggered by pubertal hormonal changes. In about 5% of the cases it is due to genetics.

"In early childhood it seems to occur as frequently in boys as girls but by adulthood 80% to 90% of reported cases are women.

"Is this because it is easier for men to hide or because there is a bigger stigma to men seeking help.

"The hair pulling can be transient and episodic or can be constant.

"Also the intensity can fluctuate."

Tracey warned parents to be alert to the symptoms and keep on eye on their children.

She said: "This disorder is more widespread than people realise, people are just good at hiding it."

80,000 are estimated to suffer from the disorder with the majority being women. However, more men may have it but fail to report condition


Inability to resist urges to pull out one's hair

For some, mounting tension before one pulls

For some, gratification and relaxation when pulling

For some, a feeling of relief after pulling

Noticeable hair loss

Increased distress and/or interference with daily life


Scalp: Can pull in just one spot or several spots. May focus on "special hairs which can create a general thinning

Eye lashes

Eye brows

Pubic hairs

Extremities: Such as the torso, legs, underarms, in the ears, nose etc. This may be done since the hair loss isn't as noticeable.

Hairs may be pulled from other people, pets, dolls and stuffed animals


It's not just a nervous habit

It's not a sign of abuse

It''s not a sign of emotional disturbance

It not your''s or your parents' fault

People with Trich are not trying to hurt themselves or do this for attention


PAIN Scalp is exposed TORMENT condition can result in severe damage
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Copyright 2010 Gale, Cengage Learning. All rights reserved.

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Publication:The Mirror (London, England)
Date:Aug 31, 2010
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