Trichotillomania in London — the hair-pulling disorder that isn't a habit
Trichotillomania is a neurobiological condition, not a habit or a phase. It responds to specific therapy — and London has the specialists to deliver it.
Dr. Amara Okafor
Consultant Trichologist · Harley Street
In short
- Habit Reversal Training (HRT) is the evidence-based therapy.
- London specialists at Maudsley (NHS) and private clinics in W1.
- Scalp examination: broken hairs of varying lengths, no scarring.
- N-acetylcysteine (NAC) has moderate evidence as adjunct.
Trichotillomania — recurrent hair-pulling with associated hair loss — affects about 1–2% of the population. It's classified as a body-focused repetitive behaviour, not a habit. Most sufferers know they pull; most cannot stop unaided; almost all improve with specialist therapy.
What a trichologist sees
- Broken hairs of varying lengths (unlike alopecia areata's clean patches)
- No inflammation, no scarring
- Often geographical patch matching dominant hand
- Trichoscopy: coiled hairs, flame hairs, black dots
Treatment — HRT is the answer
Habit Reversal Training combined with Comprehensive Behavioural Therapy is first-line. 12–20 sessions with a clinical psychologist familiar with BFRBs. NAC (1,200–2,400 mg/day) has moderate evidence and is often used adjunctively. SSRIs are second-line, mixed evidence.
Where to go in London
NHS: GP referral to psychology, or specialist BFRB clinic at Maudsley. Private: TLC Foundation-affiliated therapists, £120–£180 per session. Trichologist for scalp assessment and camouflage advice during recovery.
Trichotillomania isn't willpower. It's neurology — and neurology has treatments.
Frequently asked
Common questions
Can hair grow back fully?+
Yes — trichotillomania causes no scarring in most cases. Full regrowth follows sustained abstinence.
Is it linked to OCD?+
Related but distinct. Different treatment approach (HRT vs ERP).
My child pulls — is it the same?+
Paediatric trichotillomania often resolves; refer to specialist child psychologist.
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