Hair twirling or hair pulling, also known as trichotillomania, is a common body-focused repetitive behavior where people feel an irresistible urge to touch, twist, pull, rub or handle their hair. It can range from mild hair stroking to obsessive hair pulling that causes noticeable thinning or bald patches on the scalp.
This impulse control disorder is more common than you might think. Studies estimate that 4% of people engage in trichotillomania at some point in their lives. The condition affects men and women equally, though women tend to pull hair from their scalp, while men are more likely to pull facial or body hair. Hair manipulation can start in childhood, adolescence or adulthood and range in severity.
While not inherently dangerous, chronic hair twirling or pulling can damage hair follicles and cause breakage, frizz, split ends and hair loss over time. Socially, it can be embarrassing if the behavior is conspicuous or leads to visible hair loss. Habitual hair pulling may also indicate underlying anxiety or obsessive-compulsive tendencies.
If you want to curb excessive hair twirling or pulling, it is possible to change this behavior. But it requires diligence, self-awareness and the use of different strategies. Here is a comprehensive guide to understanding the causes, implementing solutions and stopping hair twirling for good.
Table of Contents
Diagnosing Trichotillomania
The first step is always identifying whether your hair twirling qualifies as trichotillomania based on diagnostic criteria in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). You may have trichotillomania if you:
- Feel an irresistible urge or compulsion to pull out your hair
- Experience tension, anxiety or stress right before pulling your hair or when trying to resist the urge
- Experience pleasure, gratification or relief when you pull out hair
- Result in hair loss or physical damage to the hair or scalp
- Cause significant distress or impairment in professional, social or other areas of functioning
- Are not attributable to another medical condition or mental disorder
A mental health professional can provide an official diagnosis and rule out underlying factors. But paying close attention to your own hair pulling motivations, feelings and consequences can also indicate whether it’s within the realm of trichotillomania.
Why Do People Twirl Their Hair?
To successfully change hair pulling habits, it helps to first understand what’s causing them. Trichotillomania is considered a “body-focused repetitive behavior” – actions that damage the body through habitual grooming or self-harm. Though the exact causes are unknown, it likely stems from a combination of:
Genetics
Trich runs in families, suggesting a genetic component. First degree relatives of someone with trichotillomania have higher rates of hair pulling and other body-focused repetitive disorders like skin picking. More research is still needed on the specific gene variations involved.
Brain Chemistry
Imbalances in certain neurotransmitters like serotonin may contribute to trich. Low serotonin levels are associated with many impulse control disorders. Some anti-depressant medications can reduce hair pulling by increasing serotonin.
Psychological Factors
Emotional factors like stress, anxiety, loneliness, trauma, depression, perfectionism, and boredom are commonly reported trich triggers. It may start as a self-soothing behavior that becomes compulsive over time.
Obsessive-Compulsive Disorder
Trich has close links to OCD and shares similarities like repetitive behaviors and difficulty controlling urges. Around 10-15% of people with trich also have OCD. Treating OCD may lessen hair pulling in these cases.
Other Mental Health Issues
Trich is more common in people with disorders like anxiety, depression, autism spectrum disorder, and ADHD. Managing these conditions can help reduce obsessive-compulsive hair pulling.
So in many cases, trich serves an emotional purpose and becomes a maladaptive coping strategy. Recognizing your personal triggers is key to changing the behavior.
Dangers of Chronic Hair Twirling
While occasional hair twisting is harmless, chronic hair twirling can lead to:
- Split ends – The repeated twisting motion can damage and split hairs. This causes frizziness and dryness.
- Hair breakage – Excessive force on the strands makes hair prone to snapping and breakage, especially when wet.
- Thinning hair – Pulling on hair follicles can gradually weaken them and cause temporary or permanent hair loss.
- Bald spots – Constant twisting of hair in the same area can result in smooth bald patches on the scalp.
- Hair loss – The chronic tugging associated with trichotillomania can lead to progressive hair loss.
- Scalp damage – Vigorous and forceful twisting can injure the scalp, causing soreness, redness and scabbing.
10 Tips to Stop Hair Twirling
If you want to stop hair twirling, here are 10 techniques and lifestyle changes you can try:
1. Find a Replacement Behavior
Whenever you feel the urge to twirl or pull hair, immediately do an alternate behavior that keeps your hands occupied. Some replacements to try include:
- Squeeze a stress ball
- Snap a rubber band on your wrist
- Play with a fidget toy
- Spin a coin through your fingers
- Squeeze hands together
- Tap fingers
- Build/stack objects
- Fold paper into shapes
Having a go-to replacement ready makes it easier to resist hair pulling in tempting moments. Keep fidget objects, toys, or craft supplies nearby to occupy the hands.
2. Use Physical Barriers
Putting up physical barriers can prevent mindless access to your hair. Tactics include:
- Keep hair tied up or clipped back
- Try styles like buns, braids or ponytails
- Wear gloves or bandages on hands/fingers
- Wear a hat, scarf, headband or wig
- Wrap hair in a silk scarf or towel while at home
- Consider temporarily shaving your head
Making hair inaccessible reduces temptation and friction that can damage the hair. Protective barriers are especially helpful in mindless trance-like pulling.
3. Eliminate Environmental Cues
Remove triggers in your home and work spaces:
- Get rid of magnifying mirrors and tweezers
- Install bright lighting – this helps avoid trance-like pulling
- Eliminate background noise/TV if it triggers twirling
- Keep hands busy at the computer with stress balls, cubes, etc
- Put soothing lotions and hair products out of sight
- Use short nails to reduce pulling ability
- Keep a diary and track/change high-risk environments
Controlling your immediate environment removes temptation and reduces absent-minded hair access.
4. Practice Mindfulness and Meditation
Mindfulness training teaches present-moment awareness and conscious control over urges. Useful techniques include:
- Body scans – notice physical sensations when you feel like pulling
- Observe triggers objectively without judgement
- Visualize letting go of tension in the scalp muscles
- Do conscious breathing when you catch yourself touching hair
- Yoga promotes mind-body connection and self-regulation
Regular meditation makes you more aware of hair pulling as it occurs so you can stop it. Apps like Headspace provide excellent guided mindfulness exercises.
5. Identify Underlying Emotions
Hair pulling often provides emotional relief or distraction. Get to the root feelings driving the urge:
- Keep a feelings journal tracking your emotions around episodes
- Notice if boredom, sadness, anger, anxiety, or stress precede pulling
- Practice calming rituals like deep breathing when difficult emotions emerge
- Develop healthy methods to express feelings like exercise, art, or calling a friend
- Consider counselling to uncover subconscious motivations
Finding alternative emotional coping outlets lessens dependence on hair pulling over time.
6. Consider Habit Reversal Training
Habit reversal training uses three steps to rewire the behavioral response:
- Awareness training – Recognizing pulling when it happens
- Competing response – Immediately doing a replacement behavior when you pull
- Motivation – Tracking progress and reinforcing reasons for change
One study found 70% of people experienced reduced hair pulling after 8 weeks of habit reversal training. It takes consistency but can be very effective at retraining the mind and body.
7. Seek Professional Help
For severe, uncontrollable cases of trichotillomania, seek help from a doctor, psychiatrist or therapist. Treatment options may include:
- Cognitive behavioral therapy (CBT) to change thought patterns around hair pulling
- Exposure and response prevention (ERP) to resist hair pulling urges
- Medications like SSRIs, anti-anxiety, or ADHD medications
- Alternative approaches like hypnosis, acupuncture, biofeedback
Professional support teaches strategies for long-term change and helps understand any underlying disorders exacerbating the condition.
8. Consider Medication as Needed
Though not a sole solution, certain medications can support trich recovery:
- SSRIs like Prozac curb obsessive-compulsive urges
- Anti-anxiety medications like benzodiazepines reduce stress triggers
- N-acetylcysteine (NAC) balances glutamate levels in the brain
- Opioid antagonists like naltrexone block pleasure receptors activated by pulling
Medication works best with therapy. Discuss options carefully with both your psychiatrist and dermatologist.
9. Get Social Support
Don’t go it alone. Enlist help from loved ones, support groups and online communities:
- Tell friends and family about the condition and how they can help
- Seek a treatment buddy who checks in on your progress
- Find a local trichotillomania support group
- Join forums like the TLC Foundation for peer advice
Validation and accountability from others gives you added motivation to keep trying.
10. Practice Self-Care
Stress and fatigue worsen trich urges. Ensure good self-care:
- Get regular exercise to reduce anxiety
- Follow a nutritious, balanced diet
- Set a consistent sleep schedule and wind down before bed
- Give yourself relaxing mini-breaks during the day
- Take up hobbies, interests or social activities you enjoy
- Reduce overall obligations if you’re overwhelmed
When you’re in a healthy emotional state, you’ll have more willpower to resist hair pulling.
Stopping trichotillomania takes tremendous patience, dedication and compassion towards yourself. But implementing a mix of lifestyle changes, replacement habits, environmental control, emotional awareness and support from others sets you up for success. With diligent practice of new coping skills, the compulsion lessens and hair pulling urges gradually subside.
When to Seek Help
While most people can stop hair twirling on their own, consider seeking professional help if:
- You cannot control the urge to twirl and pull out hair
- Your hair twirling habit is getting worse
- You have noticeable hair loss or bald spots
- Hair twirling causes you distress or impacts daily life
- You feel depressed, anxious or embarrassed by the habit
Seeing a doctor, psychologist or trichologist can provide solutions. Treatment may involve habit reversal training, cognitive behavioral therapy (CBT), support groups and medication.
Frequently Asked Questions
Q1. Why do I twirl my hair all the time without realizing it?
Most people twirl their hair unconsciously as a self-soothing mechanism or mindless fidgeting habit. Stress, boredom, distraction and anxiety are common triggers. It can become an automatic behavior that you don’t notice.
Q2. How can I make myself more aware of hair twirling?
Using reminders helps. Put up notes that say “stop twirling” where you’re likely to do it. Ask someone to point it out when you twirl hair. Set phone alerts at certain times. Being more mindful and meditating also raises awareness.
Q3. Is it normal to twirl hair as a child?
Yes, it’s common for kids to twirl hair while watching TV or when bored. If it becomes excessive to the point of hair loss or distress, consult a child psychologist. Use positive reinforcement like stickers to reward abstaining from hair twirling.
Q4. Does cutting hair short help stop twirling it?
Yes, very short haircuts make it impossible to grasp strands to twirl. Go for styles like pixies and bobs. If you can’t hold onto the hair, you can’t twist it. This works best along with behavior modification techniques.
Q5. Can I pull out eyelashes, eyebrows or other body hair?
No, redirecting hair pulling urges to different body parts will still damage that area. The goal is stopping body-focused repetitive behaviors entirely through habit reversal training. Fidget toys and other substitutions help redirect the impulse.
In Conclusion
Hair twisting is a common habit but it can progress into a damaging disorder like trichotillomania. Being aware of triggers and implementing lifestyle changes can help end the urge to constantly twirl hair. Seek professional guidance if behavior therapy and self-help techniques don’t work. With consistent effort, it is possible to stop hair twirling for good.