This is one of the bigger advances we’ve had within this field in a long time,” said Doug Woods, associate professor of psychology at the University of Wisconsin, Milwaukee.
Psychologists are still debating how to categorize trichotillomania, Woods said. Many believe it is related to obsessive compulsive disorder, but others liken it to addictions or impulse control disorders.
Researchers are unsure of exactly what goes on in the brain with this disorder. Some people with trichotillomania feel pleasure in pulling hair, while others describe it as “calming,” and still others have no idea why they do it, Grant said. There may be differences in the brain pathways among people with the condition, he said.
For Pearson, pulling hair up made her feel as if her whole nervous system lit up, she said.
“Basically my fingers would search for a texture, a certain type of hair, when I found it, I would pull it out,” she said. “I would feel like I had found gold.”
The condition affects primarily women and usually begins in childhood or adolescence, Woods said.
The term, coined in 1889 by a Greek physician, comes from the Greek words for its features: “tricho” means “hair,” “till” means “to pull,” and “mania” means “frenzy.”
Long before the disorder had a name, the idea of compulsive hair-pulling had been known for hundreds of years, Woods said.
The two main kinds of medications that have been used for trichotillomania are selective seratonin reuptake inhibitors — SSRIs, used for depression — and the OCD drug chlorimipramine, Woods said. The antidepressants may help patients’ anxiety and depression but don’t actually help the pulling, whereas chlorimipramine has been shown to dampen the pulling impulse somewhat.
But the treatment that has demonstrated the most effectiveness so far is behavior therapy, Woods said.
The dietary supplement probably will not replace the need for behavioral therapy, but future research may find that they two approaches work well together, Grant said.
Before trying N-acetylcysteine, people should consult their physicians, particularly to determine whether there are interactions that the supplement could have with other medications the patient already takes, Grant said.
Experts say there are still many people who compulsively pull their hair and don’t know that they are not the only ones.