Understanding Trichotillomania and Its Management with Homeopathy

Abstract
TRICHOTILLOMANIA  is a mental health disorder where a person compulsively pulls out or breaks their own hair. This condition falls under the classification of Obsessive-Compulsive Disorder (OCD). For this a 30 years old female patient came to OPD and was treated successfully with the help of Homeopathic Remedy in a few months. This article contains following points –

1. What is Trichotillomania?
2. Different rubrics related to Trichotillomania 
3. Case of Trichotillomania which is cured by Homeopathic medicine – Belladonna 

Keywords: Trichotillomania, Mental health disorder, OCD, Homeopathy 

Introduction

TRICHOTILLOMANIA is a disorder of adult personality and behavior which is characterized by Impulsive behavior which the patient cannot resist or control. TRICHOTILLOMANIA comes from three Greek words _

• TRICHO : hair
• TILLO : pull
• MANIA : excessive behavior or activity

TRICHOTILLOMANIA ( Compulsive Hair- Pulling ) is characterized by noticeable hair loss caused by a person’s persistent and recurrent failure to resist impulses to pull out hair. There is an intense urge to pull out hair with mounting tension before the act and a sense of relief afterwards. This is not secondary to any lesion or inflammation or any delusion or hallucination. There may be feelings of release of tension by doing an act and a feeling of guilt after the act is over.

Risk Factors

The cause of Trichotillomania is not clear, But following factors tend to increase the risk of TRICHOTILLOMANIA :

• Family History of Trichotillomania.
• Age : Usually develops just before or during the early teens — most often between the ages of 10 and 13 Years. 
• Other mental health conditions, such as depression, anxiety or Obsessive-Compulsive Disorder (OCD) may occur along with Trichotillomania.
• Severely stressful situations or events may trigger Trichotillomania in some people.
• An environment like Boredom, isolation and privacy often increase the likelihood of hair pulling.

Management:

• Cognitive Behavioral Therapy
• Psychotherapy
• Pharmacotherapy like Fluoxetine

Homeopathic Management

Some rubrics for TRICHOTILLOMANIA 

• RUBRIC : [Synthesis] Mind – Pulling – hair

MEDICINE : ant-c, ant-met, Ars, bar-c, Bell, canth, cham, Cupr, dig, dulc, germ-met, lach, Lil-t, Med, merc, mez, staph, stram, tarent, tub, verat, xanth

• RUBRIC : [Synthesis] Mind – Pulling – hair – desire to pull – her own hair

MEDICINE : Ars, Bell, Cupr, dig, germ-met, ign, lach, lil-t, med, staph, tarent, tub, xanth

• RUBRIC : [Synthesis] Mind – Pulling – hair – desire to pull – her own hair – alone, when 

MEDICINE : staph

• RUBRIC : [Synthesis] Mind – Pulling – hair – desire to pull – her own hair – pain, from 

MEDICINE : tub

• RUBRIC : [Synthesis] Mind – Pulling – hair – presses her head; and 

MEDICINE : tarent

Case of  Trichotillomania

HISTORY :

A 30 years old female patient came with the complaint of Itching on Scalp ++ since 5 months which is better by Pulling her hair +++

On further asking,

The patient said that she had a desire for pulling her hair +++, which she can’t resist… ( After sometime, she revealed that, desire is occurred especially on Vertex area.. )

On Examination, 

There is visible Hair loss on the vertex area… 

Also she had Hair falling especially on Vertex area ++ 

VITAL PARAMETERS :

• Blood Pressure – 122/80 mm of Hg
• Pulse – 76/min
• Respiratory rate – 16/min
• SpO2 – 98% at RA
• Temperature – Afebrile 
• Respiratory system – B/L airway entry clear
• Cardiovascular system – HS1 HS2 heard
• Gastrointestinal system – per abdomen soft
• Central nervous system – no abnormal neurological sign

PAST HISTORY : Recurrent Cough and Coryza in childhood 

FAMILY HISTORY : Father died of Myocardial Infarction 

PHYSICAL GENERAL : (Significant)

• Desire for Pica ( Undigested food – Chalk, Clay )
• Aversion to Milk causes Vomiting 
• Patient is Chilly

MENTAL ASPECT :

Patient is born and brought up in middle class family in Uttarpradesh. She is diligent and good in studies. Right handed. Timid bashful +++ Speed average. Intellect dull. Need esteem. Since childhood she confused in shopping and other purchases. She was having fear of water and fear of dogs +++ Anxiety consciousness +++

REMEDY – 

I gave her Belladonna 200 × 1 dose followed by Placebo × 15 days…

After 15 days, Patient felt 10% better internally, 1 dose again repeated.

After 1 month, Patient’s condition is stand still, so Belladonna 200 × 3 doses given OD..

After 1 month, again 3 doses of Belladonna 200 repeated for further recovery.

After 2 months, Patient was better 80%, Belladonna 1M single dose was given.

After 2 months, Patient become Asymptomatic and stopped the treatment.

Conclusion

Homoeopathic science treats the patient as a whole, not the clinical diagnosis. Here we can see the efficacy of Homeopathic medicine in such types of psychological cases with complete recovery of the patient. The role of homoeopathic Repertory is also essential to reach out to the most suitable remedy for the patient.

References :

1. https://my.clevelandclinic.org/health/diseases/9880-trichotillomania
2. https://www.mayoclinic.org/diseases-conditions/trichotillomania/symptoms-causes/syc-20355188

The Essential Synthesis by Schroyens DF, 2nd ed. (Page no 170)