Department of Psychiatry

Penn Behavioral Health

Trichotillomania and Excoriation Disorder

Trichotillomania Overview

Trichotillomania (or hair-pulling disorder) is characterized by the recurrent pulling out of one’s own hair. Hair pulling may occur from any region of the body in which hair grows; the most common sites are the scalp, eyebrows, and eyelids. Individuals with trichotillomania have made repeated attempts to decrease or stop hair pulling and the pulling often results in feeling a loss of control, embarrassment, and shame. Hair pulling may be accompanied by a range of behaviors or rituals involving hair, such as searching for a particular kind of hair to pull, pulling hair in a specific way, or examining or feeling the hair after it has been pulled.

Excoriation Disorder Overview

The essential feature of excoriation (skin-picking) disorder is recurrent picking of one’s own skin. The most commonly picked sites are the face, arms, and hands, but many individuals pick from multiple body sites. Individuals may pick at healthy skin, at minor skin irregularities, at lesions such as pimples or calluses, or at scabs from previous picking. Most individuals pick with their fingernails, although many use tweezers, pins, or other objects. In addition to skin picking, there may be skin rubbing, squeezing, lancing, and biting. Individuals with excoriation disorder often spend significant amounts of time on their picking behavior, sometimes several hours per day.


Back to Top