Protocol · Mental Health
Trichotillomania (Hair-Pulling Disorder) Supportive Care Protocol
N-Acetyl Cysteine (NAC) and Inositol are the core of this stack, with 6 supporting supplements. Each row gives the amount the protocol lists and the grade our evidence database holds for that supplement in Trichotillomania (Hair-Pulling Disorder) Supportive Care.
We are re-verifying the studies cited on protocol pages; only confirmed citations are shown.
The stack
8 supplements · 1 graded · 1 confirmed study
| Grade | Supplement | Amount listed | Why it’s in the stack | Evidence on file | Shop |
|---|---|---|---|---|---|
| Primary stackThe core of this protocol | |||||
| N-Acetyl Cysteine (NAC) | Amount listed: 1,200–2,400 mg daily in divided doses | Glutamate modulator; best-studied supplement for trichotillomania; reduces urge to pull
| Grade D for Anxiety Symptoms50 people | ||
Confirmed studies for N-Acetyl Cysteine (NAC) (titles as PubMed lists them) | |||||
| Inositol | Amount listed: 12–18 g daily in divided doses | May help with impulse control through serotonin pathway modulation | Not graded yet | ||
| Supporting stackListed as additions to the core | |||||
| Omega-3 Fatty Acids | Amount listed: 2–3 g EPA+DHA daily | Supports brain health and mood; may help with impulse control | Not graded yet | ||
| Magnesium | Amount listed: 300–400 mg daily | Supports nervous system function; may help with anxiety and stress that trigger pulling | Not graded yet | ||
| B-Complex Vitamins | Amount listed: B-complex daily | Supports nervous system and mood; may help with stress management | Not graded yet | ||
| Vitamin D | Amount listed: 2,000–4,000 IU daily | Supports mood; deficiency linked to various mental health conditions | Not graded yet | ||
| Silica | Amount listed: 5–10 mg daily | Supports hair regrowth and strength once pulling stops | Not graded yet | ||
| Biotin | Amount listed: 2,500–5,000 mcg daily | Supports hair regrowth after pulling stops | Not graded yet | ||
Shop the evidence-backed picks
Support alongside medical care. These supplements are not a treatment for Trichotillomania (Hair-Pulling Disorder). If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.
The collection holds the supplements we grade A or B for its theme, in third-party tested products where the catalog has them. It opens in our Fullscript store. You can look through it without signing in; Fullscript asks for a free account to order.
Or shop one supplement
Each opens third-party tested products, matched to the dose above where we can.
- Grade D
We earn from purchases made in our Fullscript store, and links to Fullscript, iHerb or Thorne carry our referral, so we may earn a commission at no extra cost to you. Grades come from the research and never change based on what we earn. Full disclosure
How this protocol works
In plain language
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.