P8.96 TRICHOTILLOMANIA – AN IMPORTANT CAUSE OF DIFFUSE ALOPECIA

Murugusundram S ,Shivakumar S ,Yesudian P.

Skin Hair & Nail Clinic , Chennai , INDIA

Trichotillomania is often concealed by the patients. It is also often not identified by the physician. In a large study of diffuse alopecia, we found quite a number of cases of trichotillomania.

We report 35 cases of trichotillomania out of 3500 cases seeking help for diffuse hair loss. Trichotillomania was observed more often in females. It was present in all ages from 13 to 65 years. Careful history taking revealed psycho-social stress in all cases. Psychiatric disorders like major depresssion and OCD were seen in only a few cases. Few had first degree relatives who had psychiatric disorders. Counselling and psychiatric consultations were arranged for all of them. Selective serotonin reuptake inhibitors proved to be successful treatment for these patients on a long term basis.

Hair represents beauty, virility & sexuality. Trichotillomania is an impulse control disorder. Rising incidence of this problem is an eye-opener in evaluating psycho-social stress in diffuse alopecia.