With her blonde hair tied back in a ponytail and dressed in a chic business suit that reeks of Chapel Street, Stephanie Carovella looks every bit the successful lawyer that she is.  But as she takes her hair out of her ponytail, it’s obvious that things aren’t quite what they seem. Forget the blonde tumbling mane men often fantasize about. Instead Stephanie’s hair is thinner than most, strands are brittle, and bald patches that were covered up by the ponytail are now evident.

She doesn’t, however, have alopecia, the medical condition that causes sudden hair loss from shock, stress, or hormonal balances. Stephanie has something completely different, something that has caused her to pull out her own hair. She has Trichotillomania or TTM as it’s often called, and she’s not alone. Millions of people all over the world suffer from Trichotillomania, although it is mainly females that suffer from this condition.

Many may be asking right now, "Tricho what?" Deriving from the Greek word Trich (hair) tillein (to pull) and maniaor frenzy (morbid desire), Trichotillomania is a condition not unknown to doctors. Unfortunately it is one of very little understanding.

Its main characteristic is the compulsive urge to pull one’s hair out, with then an experience of released tension and relief after this is done. Sometimes people even express a degree of pleasure after having performed the act.

It tends to usually start at around five to eight years of age. Although it affects both males and females, by the teenage years and particularly among adults, more women appear to have this disorder, as boys tend to change their behaviour upon adolescence.
There is a ratio of five to ten women to every man. But these figures may be distorted due to the fact fewer men seek help, and natural balding can disguise hair-pulling in men.

Stephanie started pulling out her hair as a child, but it wasn’t until her teen years that her condition got worse. “I can recall twirling my mother’s hair when I was a baby, and then my own. I think I was about seven when I actually started to pull out my hair. At first it wasn’t a big deal, and I’d just sit there watching television and pulling,” she says.
“But then it became a habit, and when I got into my teen years it got worse. As the pressures of school and just being a teenager increased I’d lock myself in my room, and pull away. I started doing it while I was reading, then before I fell asleep at night. Almost as if it was a source of comfort.”

Although there are only one to two percent of the world’s population that are officially diagnosed with Trichotillomania, the stigma and shame associated with it suggests that an estimated two to three percent more suffer in silence. Widespread ignorance or misinformation about this disorder, even among professionals, often compounds this.