Traumatic baldness or Alopecia Trichotillomania condition is based on an obsession with own hair. People with Trichotillomaina tug and pluck their hair making bald patches or sometimes areas of diffuse hair loss. The hair for plucking is selected from other hair based on it being different in some way, perhaps feeling rough to the touch or more curly than other fibers. Once a bald area has been made it becomes even more enticing to pull at the hair around it making the alopecia patch larger. Sometimes the hair plucking is more generalized and looks like a Alopecia Diffusa. This is generally a non-scarring non-inflammatory form of hair loss although long term repeated plucking over several years may result in a mild immune cell infiltrate and irreversible scarring damage to some hair follicles. Trichotillomania affects 2-3% of all people with hair loss making it a fairly common condition. Studies have identified the head as being the most commonly affected area. Approximately 70% of cases involve scalp hair loss, 50% involve eyebrows and or eyelashes, 30% include pubic hair, 20% body hair, and about 10% involve facial hair. Another variation is Trichokryptomania, in which patients rub or break off their hair rather than pull and pluck it. As well as plucking andbreaking off their hair, affected individuals may then chew or eat the hair. Hair eating is known as Trichophagia while hair chewing may result in hair balls Trichobezoars. About 40% of cases involve hair chewing while 10% of affected individuals eat their hair. Eating hair is rather unwise as it is very irritating to the stomach and may lead to digestion problems and ulcers. The affected individuals are often unaware of what they are doing and arrive to Trichologists complaining of hair loss from an unknown cause. Although compulsive trichotillomaniacs frequently hide or deny their hair pulling and may use make-up or wigs to conceal areas of hair loss. Trichotillomania can affect both children and adults, the mean age of onset is age 8 r boys and age 12 for girls, but the adult version of Trichotillomania affects more women with them more likely than men to pull eyebrow and eyelash hair. Males represent from 25% to 33% of all reported compulsive hair puller cases. Trichotillomaina is a neurobiological condition and may develop in people with anxiety disorders or mood problems.

 

Traction Alopecia may look similar to Trichotillomania, but it is rather a result of repeatedly pulling hair due to various styling, which involves pulling and securing hair into shape, starting from wearing tight pony tails,or buns and endng with braiding or corn rows. The over use of hair stylers such as sponge hair rollers or curling irons may also promote this condition. Traction Alopecia often shows as distinct patches of hair loss in those areas where the hair and hair follicles have been put under excessive strain. The hair loss may occur anywhere on the scalp depending on the nature of the hair style or process that is causing the traction alopecia. Traction Alopecia is a very common cause of temporary hair loss. Typically, Traction Alopecia in early stages involves affected hair follicles being pushed into the Telogen resting stage along with localized trauma to the hair follicles as a result of hair fibers being forcibly pulled out. As with Alopecia Trichotillomania, Traction Alopecia is generally a non-scarring, non-inflammatory form of hair loss although long term use of hair styles involving traction over 3 or more years may result in a mild immune cell infiltrate and irreversible scarring damage to some hair follicles. Any form of chronic Traction Alopecia will eventually lead to fibrosis around hair follicles and total destruction of some hair follicles. Once destroyed the hair follicles will not regrow under any circumstances hence chronic Traction Alopecia can be described as a Scarring baldness or Alopecia Cicatricial. Traction Alopecia is reversible if diagnosed in the early stages. An effective treatment is to simply avoid hair styling that puts excessive strain on the hair. Even with removal of the cause of Traction Alopecia it may take up to three months for the hair to recover. Areas of scalp subjected to chronic Traction Alopecia may never fully recover.