Korean J Dermatol.
2021 Dec;59(10):778-784.
A Clinical Study of Trichotillomania in 198 Cases: An Update and Cross-Time Comparison
- Affiliations
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- 1Department of Dermatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
Abstract
- Background
Trichotillomania (TTM) is characterized by recurrent hair pulling, resulting in hair loss. TTM is typically encountered in dermatology settings; however, few reports on the clinical characteristics of TTM in a large population are available.
Objective
To evaluate the clinical characteristics of TTM.
Methods
We performed a retrospective chart review of patients diagnosed with TTM between 2006 and 2019.
Results
Clinical records of 198 patients were analyzed. The average age of TTM onset was 10.8 years, and 119 patients experienced childhood-onset (at ＜12 years). Sex prevalence showed a female predominance, and the proportion of females was lower in the childhood-onset TTM than in the late-onset TTM (onset at ≥12 years). Vertex was the most commonly involved site. A history of stressful situations was noted in 48 patients (24.2%). In the group with a poor prognosis, the number of patients with ≥25% scalp invasion was significantly more than the other group. The average duration of hair loss to more than 50% recovery was 4.88 months for childhood-onset TTM cases and 9.83 months for late-onset TTM cases. The prognosis was significantly better in the childhood-onset TTM than in the late-onset TTM. Nail biting and folliculitis were the most common co-occurring repetitive behavior and comorbid disease, respectively.
Conclusion
Unlike previous domestic studies, patients with childhood-onset TTM had a female preponderance. Moreover, the proportion of patients who experienced a stressful situation was higher than that reported in a previous study. In addition, patients with severe disease and late-onset TTM had a significantly poorer prognosis.
