Trichotillomania describes a condition in which an individual repeatedly pulls his or her hair out of one’s head or other body parts due to an obsessive-compulsive disorder (OCD). Sometimes trichotillomania is accompanied by ingesting the hair causing a condition of indigestible hair products in the stomach known as a trichobezoar that may require surgical excision. Patterns of hair loss are typically unusual and follow the center of the scalp more where there is less pain with excision than the periphery of the hair, where nerve sensation is greater.

The question that I encounter as a hair-transplant surgeon is whether I should offer a hair-transplant procedure to someone who has this condition. This is obviously a complicated question, as it truly depends on the person and the extent, periodicity, and current state of the problem. Here are two extremes. Someone that is currently suffering from the problem clearly is not a surgical candidate for two reasons. First, sometimes the plucked hairs come back if they are not overplucked. Second, the ongoing nature of the psychological condition must be treated with anti-OCD medications before even contemplating the possibility of surgical intervention. The opposite extreme is someone who had this condition when he or she was a child and has now many years out from it no longer has any desire or proclivity to engage in that behavior. Working with a psychologist or a psychiatrist can help a surgeon determine the candidacy for a suffer of trichotillomania to undergo a hair-restoration procedure.

Samuel M. Lam, MD, FACS, a board certified hair transplant surgeon in Dallas, Texas. To learn more about trichotillomania, or to schedule a consultation please call 972-312-8105, or visit for more info. To ask Dr Lam a question please visit our hair loss forum.