[Trichoteiromania]

Abstract

Background: The physical influences leading to traumatic hair injury may be the result of cosmetic treatments, may be accidental or self-inflicted. The most frequent cause of self-inflected hair loss is trichotillomania, in which the hair is plucked, while trichotemnomania, in which the hair is deliberately cut, is less frequent. Freyschmidt-Paul et al. proposed the term trichoteiromania for yet another type of artificial hair loss, which results from perpetual rubbing of the scalp with fracturing of the hair shafts.

Patients and methods: Four patients with trichoteiromania are further characterized on the basis of clinical, morphological and psychopathological criteria.

Results: In contrast to trichotillomania, trichoteiromania has no diagnostic histopathological features and has a normal trichogram. Traumatic changes to the hair shaft are more conspicuous, with splitting at the ends of the hairs, giving the impression of white tips. The underlying mental disorder varis among the patients, though scalp dysaesthesia, not explained through any specific dermatological disorder, is a common denominator in all cases.

Conclusions: While trichotillomania is considered to be an obsessive-compulsive disorder, the underlying mental disorder in trichoteiromania represents a more heterogeneous group. Cooperation with the psychiatrist is indicated, as much as the management and prognosis of trichoteiromania will depend on recognition of the underlying mental disorder and its specific psychotherapeutic and pharmacological treatment.