Trichotillomania (Hair Pulling)

Trichotillomania is the compulsion to pull out one's hair.

Quick Answer

What it is

Trichotillomania is the compulsion to pull out one's hair.

Key findings

Grade D: Anxiety Symptoms (N-Acetylcysteine)
Grade N/A: Depression Symptoms (N-Acetylcysteine)
Grade N/A: Subjective Well-Being (N-Acetylcysteine)

Safety

No specific caution or interaction language was detected in the current summary/outcome notes.

ℹ️ Quick Facts

Quick Facts: Trichotillomania (Hair Pulling)

Supplements Studied:1
Research Trials:1
Total Participants:50
Top Supplement:N-Acetylcysteine (C)

1 trials

50 participantsppts

1 supps · 4 outcomes

Evidence-Based Protocol

Supplement stack ranked by research quality

Limited Evidence

Primary Stack (Tier 1)

N-Acetyl Cysteine (NAC)A

1200-2400mg daily in divided doses

Glutamate modulator; best-studied supplement for trichotillomania; reduces urge to pull

5 studies | 200 participants

InositolC

12-18g daily in divided doses

May help with impulse control through serotonin pathway modulation

3 studies | 80 participants

Supporting Stack (Tier 2)

Omega-3 Fatty AcidsC

2-3g EPA+DHA daily

Supports brain health and mood; may help with impulse control

4 studies | 100 participants

MagnesiumC

300-400mg daily

Supports nervous system function; may help with anxiety and stress that trigger pulling

4 studies | 100 participants

B-Complex VitaminsC

B-complex daily

Supports nervous system and mood; may help with stress management

4 studies | 100 participants

Vitamin DC

2000-4000 IU daily

Supports mood; deficiency linked to various mental health conditions

4 studies | 100 participants

SilicaC

5-10mg daily

Supports hair regrowth and strength once pulling stops

3 studies | 100 participants

BiotinC

2500-5000mcg daily

Supports hair regrowth after pulling stops

4 studies | 150 participants

How It Works

Trichotillomania (TTM) is a hair-pulling disorder where people feel compelled to pull out their hair from the scalp, eyebrows, eyelashes, or other body areas. It's classified as an obsessive-compulsive related disorder and affects about 1-2% of the population.

CHARACTERISTICS:

•Recurrent, compulsive hair pulling

•Tension before pulling or when resisting

•Relief or pleasure when pulling

•Noticeable hair loss

•Distress or impairment in functioning

•Not due to another medical condition

PATTERNS:

•Automatic: Pulling without awareness (while reading, watching TV)

•Focused: Deliberate pulling with awareness of urge

•Most people have both patterns

CRITICAL: Trichotillomania is a recognized mental health condition that benefits from professional treatment. This protocol is SUPPORTIVE ONLY.

EVIDENCE-BASED TREATMENTS:

•Habit Reversal Training (HRT): Most effective behavioral treatment

•Cognitive Behavioral Therapy (CBT): For thoughts and emotions around pulling

•Acceptance and Commitment Therapy (ACT): Building psychological flexibility

•Medications: SSRIs, clomipramine, olanzapine (off-label)

ASSOCIATED CONDITIONS:

•Anxiety

•Depression

•OCD

•Skin-picking disorder

•ADHD

* N-Acetyl Cysteine (NAC) has the strongest evidence for trichotillomania - shown to significantly reduce symptoms in controlled trials.

* Hair regrowth supplements (biotin, silica) can support hair regrowth once pulling is controlled.

Expected timeline: NAC may show benefit within 6-12 weeks. Behavioral therapy typically requires 10-20 sessions. Hair regrowth takes several months after pulling stops.

Generated from peer-reviewed researchSchema v2.0

Supplements for Trichotillomania (Hair Pulling)

Sorted by strength of evidence

CN-Acetylcysteine

2 outcomes · 4 studies

Anxiety Symptoms↓Depression SymptomsImproves↑Subjective Well-BeingImproves

Detailed Outcomes

Anxiety Symptoms

No effect

1 study50 participants

none

Depression Symptoms

1 study50 participants

↓Improves

Subjective Well-Being

1 study50 participants

↑Improves

Trichotillomania Symptoms

1 study50 participants

↓Improves

Research Citations (34)

Safety and tolerability of N-acetylcysteine in cocaine-dependent individuals

Am J Addict

PMID: 16449100

The administration of N-acetylcysteine reduces oxidative stress and regulates glutathione metabolism in the blood cells of workers exposed to lead

Clin Toxicol

PMID: 23731375

N-Acetylcysteine Attenuates Fatigue Following Repeated-Bouts of Intermittent Exercise: Practical Implications for Tournament Situations

Int J Sport Nutr Exerc Metab

PMID: 21896942

N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study

Arch Gen Psychiatry

PMID: 19581567

New developments in the treatment of COPD: comparing the effects of inhaled corticosteroids and N-acetylcysteine

J Physiol Pharmacol

PMID: 16204787

Induced sputum of patients with chronic obstructive pulmonary disease (COPD) contains adhesion-promoting, therapy-sensitive factors

Inflamm Res

PMID: 10778915

N-acetylcysteine add-on treatment in refractory obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled trial

J Clin Psychopharmacol

PMID: 23131885

Systematic review and meta-analysis of the efficacy of N-acetylcysteine in the treatment of acute exacerbation of chronic obstructive pulmonary disease.

Ann Palliat Med

PMID: 34237968

Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trial

Lancet

PMID: 15866309

Long-term oral n-acetylcysteine reduces exhaled hydrogen peroxide in stable COPD

Pulm Pharmacol Ther

PMID: 15607126

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