Trichotillomania Treatment

| Modified on Nov 14, 2022
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N-Acetyl Cysteine
Posted by Su (Australia) on 05/27/2018
★★★★★

Editor's Choice

I have pulled scalp hair for the last 21 years. I have gone pull free only twice before for max 5 months. This time I tried NAC. I can't take more than 600mg a day due to nausea from the tablets but it helped me stop for the last 4 months. I stopped taking it at 3 weeks.The urge came back around 3 months so I started the tablets again.

Fungal theory mentioned in a post below is very interesting because I have always suffered from thrush.

Good luck for everyone trying. Don't give up.


Dietary Changes
Posted by Trina (Minneapolis, Mn) on 04/19/2018

Everything you mentioned below is an indication of toxic overload, especially being exposed to mold. It sounds like you had a high level of toxic buildup from the copper-based shampoo (heavy metal toxin), medications, birth control pills, mold and all the other chemicals, heavy metals, and pollutants everyone is exposed to these days. So your bucket was 80-90% full, then the birth control pills caused your bucket to overflow.

"My hairpulling started at 18 when I went on birth control pills. my hair fell out in clumps when I ran my fingers through it, and then I just started to coax it out, which developed into trichotillomania. I was on other meds for ADD and depression at the time, as well as having used a copper-based shampoo/conditioner for many years (gave me a weird scalp rash occasionally). I was also living in a moldy dorm room. Never in my life had I pulled out my hair prior to this time, and the bcp seemed to be the catalyst."

If you properly detox from mold as well as heavy metals and environmental chemicals (which everyone has to varying degrees), all those issues would clear up along with the hair pulling. And you wouldn't need to follow such a strict restrictive diet, which is very hard to sustain for a long time.

Trichotillomania (hair-pulling) is a form of Obsessive Compulsive Disorder (OCD), many of which are caused by toxicity. You will find many articles if you google OCD and mold toxicity, heavy metal toxicity, copper toxicity, mercury toxicity etc.

Also, might want to try taking probiotics. They are beneficial to everyone in general. This article written by an MD gives information and an amazing success story. https://www.greatplainslaboratory.com/articles-1/2016/8/10/examining-the-gut-brain-connection-and-its-implications-for-trichotillomania-treatment

But keep in mind that it's best to find an alternative health practitioner to help you do a safe, proper, supervised detox protocol. Just doing a short term detox diet, liver cleanse, bowel cleanse, foot baths, or fasting is not going to be enough to alleviate any serious symptoms like OCD or anything else. Detoxification has a long list of benefits, especially over the long term in alleviating symptoms, chronic conditions, and preventing future illness and disease.

Hope that helps someone!


Apple Cider Vinegar
Posted by Vicki (Hemphill, Texas) on 01/18/2018

Thanks for the tip. I will try the apple cider for vinegar and honey today


N-Acetyl Cysteine
Posted by Jo (Melbourne, Australia) on 01/13/2017

Did you ever try the NAC? I see the need to also support the nervous system and anxiety/stressors. In my research, the mineral magnesium and herbs (lemon balm, adapatagons and nervines such as Kava) can help. I am about to embark on some supportive measures for my 5 yr. old son. How are you travelling these days? Jo, Melbourne. AUSTRALIA


N-Acetyl Cysteine
Posted by Hope (Virginia) on 10/18/2016

How are you doing now, Kathy?


N-Acetyl Cysteine
Posted by Hope (Virginia) on 10/18/2016

Is there any more current information that you all have found helpful? I've read all the posts and am so grateful for some options to try that are natural and harmless. I'm 46 and probably started when I was 10-12, I don't remember. I've never sought treatment as all the research I have done seems to take a psychiatric route and that has never felt right to me. Reading today about the possibility of a fungus, candida, or chemical imbalance problem really makes more sense to me as the intensity comes and goes. Recently I've had some serious episodes, so much so that my hair stylist commented and I had to create a lie. These periods cause me to feel horrible about myself but I really believe there is a reasonable cause and a viable, natural solution. Thank you to all who posted thus far and to any current posts that you all create. Blessings to all my beautiful partners on this challenging journey.


Apple Cider Vinegar, Coconut Oil Cream
Posted by Nicole (Alaska) on 01/08/2016
★★★★★

Found a recipe for "keratosis pilaris" I picked all the time because of this. they look like black or white heads and scar really nasty no matter what. Its:

  • 2 oz. coconut oil
  • 2oz. apple cider vinegar
  • 1tbs. sun flower LECITHIN
  • ( emulsifier)

you melt the oil on very low heat and it doesn't need much else but mixing.

This makes a cream that will smooth out all the bumps that are addictive to scratch upon. I would advise to also wear pajama pants or long sleeves around the house so you cannot see your legs or arms. it takes a couple months to heal and become smooth. it happens faster if you apply 4 times a day. This is the only thing that has helped but I get lazy with it and wear shorts and I start picking all over again, its so UGLY! I keep saying " oh next year I'll wear shorts" but it never comes. but my legs are getting better. just be consistent. this is the only thing that works!!! & wear pajama pants. every time I see my legs with bumps I want to scratch them off & it just perpetuates the problem. It smells a little offending but it absorbs and goes away quick.

After I used this I could not believe my legs looked like I was teenager again. they were still scarred but totally smooth. vinegar makes scars go away too though.

Love you all and wish you all the best of luck to your health. THANK YOU EARTH CLINIC!!!


N-Acetyl Cysteine
Posted by Cayita (Ontario, CA) on 02/16/2015

Kathy, I suffered from this problem since I was 12 years old. Now I am 47. A year ago I started spraying Epsom Salts mixed with water on my scalp several times during the day. When it dries you have to kind of shake the salt from your hair. About 1 Tablespoon in 2 - 3 oz of hot water, mix well and spray. I keep it in my spray bottle. It totally helped. I still spray after washing my hair, it actually helps to give volume too. For eyebrows and eyelashes you can try mixing the Epsom Salt with an oil.


N-Acetyl Cysteine
Posted by Kathy (Gresham, Or) on 12/22/2014

Hello everyone, I'm a 53 yr old women, and have been pulling my hair out since I've been 8yrs old. It is the worst it has ever been. My Doctor put me on Luvox 4 month's ago and it hasn't helped at all. Infact, it's gotten worse. This the first time asking for help. So please, to anyone out there who can help me at all or just a little, I would be so greatful. Tired of hiding.


Apple Cider Vinegar
Posted by Nicole (California, US) on 10/23/2014

The Apple Cider vinegar works? Really? Do I drink it and what kind should I get? Just regular Apple Cider Vinegar from the store?


Apple Cider Vinegar
Posted by Anna (Annapolis, Md) on 05/05/2012

What really worked for me was a trich stop oil that I bought on line. It really helped with the itching and that insistent feeling that the follicles just needed relief. It's made of all natural oils so I felt good using it - no chemicals for me. I did use it with the kit that came with it that had some vizualisation, worksheets and journals. I do think that helped because you have to be ready mentally to stop as well. I think having the whole kit helped me attack it from several angles and now I've been pull free for quite awhile and feel strong and able to stay pull free. Good luck everyone!


Dietary Changes
Posted by Kitty (London, Ontario Canada) on 06/24/2011
★★★★★

I agree completely. My experience is that after going on an anticandida diet, one day I realized that I had not pulled for a number of days. After eating sugary or hi carb foods, the urge returns.


Dietary Changes
Posted by Jenna (Fresno, Ca) on 02/24/2010

Heather! Thank you so much for your candor. I'm going to look into the ACV and a diet change immediately.

I'm 28 and don't know what is wrong with me. I've been pulling hairs out of my body for as long as I can remember, but it hasn't been until the last couple of years that I've felt out of control about it. I'm good at hiding, so I mess with my scalp or parts of my body covered by clothes. I also pick quite a bit at imperfections on my skin. In high school I got the feeling that I was more prone to ingrown hairs than other girls who never had issues with shaving. I'd fish out my ingrown hairs and then make things a lot worse. I'd get little pimples on my head and pull those hairs out. And then I have combination hair where some are really coarse, so I'd go find those. Now I'm sitting here with weird patches on my scalp. They're not too noticeable, but there everywhere. And all of these little, coarse hairs have started growing back and they stand straight up. I'm so so tired of deliberately pulling out hairs and justifying my reasons for doing so. I know they don't make sense, but I can't get my hands to stop. I'm also terrible with mosquito bites. Maybe our skin is just more sensitive than most. That's got to have some positive sides.

Anyway, aside from the straight TTM, I feel like there are more things that are related, especially if we're talking about fungus. Then--and I know this seems totally unrelated--I felt like I had a permanent UTI or something strange for about a year. I went to the doctor a few times, not an STD, and was either given antibiotics for a UTI or told that there was nothing wrong with me. THEN I had a really stressful time about a year ago and had this weird outbreak of folliculitus, mostly on my chest. Then a few months ago I was finally diagnosed with ADHD and am just now in the beginning stages of getting some perspective on my life--what's real and what's not. Anyway this was a really long way to say that I think all of it--not the ADD, just the weird health and TTM problems--is related to fungus. I'm starting ACV tomorrow.

Until tomorrow, I'll share something that has been a little beneficial. The only thing that I've noticed has ever helped me is fish oil. I've taken it off and on over the years for brain reasons, but have recently become more diligent because of the ADHD. I've found that the calm it gives my brain helps me to get my hands to listen to my head. I've also heard it has anti-inflammatory qualities which might help heal what I've broken. In Dr. Hallowell's ADHD books, he recommends up to 5000mg a day (make sure it's good enough quality that it does not contain mercury!) I try to take around that.


N-Acetyl Cysteine
Posted by Anonymous (Washington, Usa) on 02/19/2010
★★★★☆

HI I wanted to add something about N-ACETYL CYSTEINE ALSO KNOWN AS NAC (THATS WHAT SUPPLIMENT LABELS WILL ADVERTIZE AS). I HAVE BEEN PULLING OUT MY HAIR SINCE I WAS A KID AND NOW I AM ALMOST 30. I HAVE TRIED DEPPRESSION MEDICINE FROM A DOCTOR, I REALLY DONT THINK APPLE CIDER VINAGER WILL WORK...WHAT A JOKE, I HAVE TRIED NOT PULLING, I HAVE GOTTEN LONG NAILS PUT ON AT THE SALON TO MAKE IT HARD TO PULL, I HAVE TRIED COUNSELING SESSIONS, I HAVE ALSO TRIED A DIET CHANGE. ALSO I HAVE OBSESSIVE COMPULSIVE DISORDER WHICH MAKES IT WORSE. ABOUT TWO WEEKS AGO I HAVE STARTED TAKING 600 MG OF NAC TWO TIMES A DAY. IT IS FROM THE SUPLIMENT STORE ( COSTS ANYWHERE FROM 8 DOLLARS TO 30 DOLLARS DEPENDING ON WHAT BRAND YOU WANT ). I TAKE IT WHEN I GET UP IN THE MORNING AND I TAKE IT BEFORE I GO TO BED. THE REASON I AM POSTING THIS REPLY IS TO TELL THE DESPERATE PEOPLE OUT THERE WHO PULL THEIR HAIR OUT AND CANT STOP THAT THERE IS HOPE. MY CONDITION IS SO BAD THAT I, AN ATTRACTIVE COLLEGE STUDENT, AM ALMOST COMPLETELY BALD AND HAVE BEEN THIS WAY FOR YEARS. I WEAR REALLY EXPENSIVE WIGS THAT I SPEND ALL MY MONEY ON TO COVER UP THIS PROBLEM. MY WIGS LOOK VERY REAL. I HAVE DONE TONS OF RESERCH ON THE NAC SUPPLIMENT AND FOUND OUT THAT THIS SUPPLEMENT IS AMAZING AND EVERYONE IN THIS WORLD SHOULD BE TAKING IT. AT THE END OF THIS POST I WILL INCLUDE A WEBSITE THAT TELLS YOU EVERYTHING NAC IS GOOD FOR. THERE HAD BEEN VERY LITTLE RESERCH ON THIS HAIR PULLING DISORDER AND MOST MEDICAL PERFESSIONALS HAVE BASICALLY LABLED THIS PROBLEM AS UNCURRABLE. IT IS NOT FAIR. AND BECAUSE OF THIS DISORDER I AM AFRAID OF GOING OUT INTO THE WORLD BECAUSE I DONT WANT PEOPLE TO JUDGE ME IF THEY NOTICE MY WIG. ITS REALLY MESSED UP. I STAYED UP ALL NIGHT AND RESERCHED NAC AND FOUND OUT IT HAS BEEN USED TO HELP PEOPLE NOT PULL OUT THEIR HAIR OR AT LEAST DO IT LESS. I HAVE BEEN TAKING THIS SUPPLIMENT FOR TWO WEEKS AND I JUST REALIZED THAT I HAVE BEEN PULLING MY HAIR OUT WAY WAY WAY LESS. AS LONG AS I KEEP MY HAND AWAY FROM MY SCALP I WILL NOT PULL. BUT ONCE I START PULLING IT BECOME HARD TO STOP. BUT WITH TAKING THE NAC I HAVE NOT BEEN PULLING OUT MY HAIR AS MUCH AND I DONT EVEN REALLY THINK ABOUT DOING IT UNLESS I REMIND MYSELF. IT IS AMAZING. I MEAN SOME TIMES I CRY BECAUSE I CATCH MYSELF PULLING MY HAIR OUT FOR HOURS. I WILL UPDATE YOU ALL AND LET YOU KNOW IF I AM PULLING ANYMORE OR NOT. SO FAR WITH ONLY TAKING THIS FOR TWO WEEKS I HAVE PULLED LESS THAN I EVER HAVE. ALL I HAVE TO SAY IS WOW AND MAYBE THERE IS HOPE. AS SUGGESTED ON SOME WEB SITES, I MIGHT GO FROM TAKING 1,200 MG A DAY TO 2,400 A DAY. ONE OF THE WEBSITES YOU CAN READ ABOUT NAC FOR MANY CURES IS:

http://clinicaltrialsfeeds.org/clinical-trials/show/NCT00993265

From http://www.ncbi.nlm.nih.gov/pubmed/19581567

Trichotillomania or hair pulling treatment

N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study.
Arch Gen Psychiatry. 2009 July. Grant JE, Odlaug BL, Kim SW. Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN 55454, USA.

Trichotillomania is characterized by repetitive hair pulling that causes noticeable hair loss. Data on the pharmacologic treatment of trichotillomania are limited to conflicting studies of serotonergic medications. N-acetylcysteine, an amino acid, seems to restore the extracellular glutamate concentration in the nucleus accumbens. Fifty individuals with trichotillomania (45 women and 5 men were tested. Half received 1200-2400 mg/d of the supplement, and the other half placebo for 12 weeks. Patients assigned to receive N-acetylcysteine had significantly greater reductions in hair-pulling symptoms as measured using the Massachusetts General Hospital Hair Pulling Scale and the Psychiatric Institute Trichotillomania Scale. Fifty-six percent of patients "much or very much improved" with N-acetylcysteine use compared with 16% taking placebo. Significant improvement was initially noted after 9 weeks of treatment. This study, the first to our knowledge that examines the efficacy of a glutamatergic agent in the treatment of trichotillomania, found that N-acetylcysteine demonstrated statistically significant reductions in trichotillomania symptoms. No adverse events occurred in the N-acetylcysteine group.


Apple Cider Vinegar
Posted by Bee (Anon, Usa) on 02/08/2010

To Jeanette- I am in the exact same situation as you- spent a lifetime pulling my eyebrows and eyelashes out- and still searching for a permanent solution! I haven't tried ACV longterm- but I have been taking N-Acetyl Cysteine 1200 mg/day with temporary success- though I have fallen into old patterns, although stress plays a huge role I think. I did use castor oil around my eyes and I wonder, if, in fact, fungus is the problem, if the castor oil helped that. Because I did have some success with the oil soothing the area which led to more pulling. Anyone with TTM knows that itching, gnawing feeling that you just have to pull certain hairs out. Without that itchy feeling, I pulled less. So I'm going back to rubbing castor oil into my eye area nightly, doesn't hurt if it gets in your eyes. Good luck to you in finding a cure and please share anything you find- I am still searching for a solution!


Apple Cider Vinegar
Posted by Jeanette (Hesperia, Ca) on 02/05/2010

Does the ACV really work for TTM? If so than I want to know is it in pill form or or liquid form. I want to know as soon as possible please tell me. I have suffered from TTM for over 18 years severely. i unfortunately pick at my eyelashes and eyebrows so I can't hide out in public. I hate it. It affects everything in my life.


Dietary Changes
Posted by Bee (Usa) on 12/29/2009

Thank you so much for sharing, Heather. I have been trying the NAC and had some initial success but the holidays have been tough and I suspect the sugar and processed foods have made the TTM a lot worse. I've always felt like sugar is a big culprit and I have crave sweets and frequently have pulling episodes after I eat a lot of sweets. I've actually recently been looking into the research of Dr. Price- I'm happy to see it helps in this area as well! I'm hoping to change my diet in the next year for other health reasons- if I could also help the TTM I would be so thrilled!


Dietary Changes
Posted by Heather (Seattle, Wa, Usa) on 12/28/2009
★★★★★

After dealing with hairpulling on a daily basis for 8 years, I have finally found an end to the urge to pull.. I've been pull free for two months now, since I adopted an anti-fungal diet (no carbs, limited fermented foods, lots of meat, veggies, animal fats, lemon) and was put on anti fungal prescription meds by my ND. The urge to pull is completely 100% gone (just as it was for the 18 years before I began to pull), and my hair is growing back beautifully, if slowly.

Some may say that two months of success is too soon to post results, but I have had this experience occur for me in the past... Back in 06, I did the exact same diet/anti-fungal regime, and had the exact same results (no more hairpulling), but I didn't know what was causing the healing to take place.. I had been doing a strict no carb/anti-fungal regimen for 4 months (Doctor Supervised!!), was able to go hat-free after three months. I decided to take a trip overseas to celebrate my success, and after a week of drinking booze, eating carbs/candy, and staying up late, the hairpulling returned with a vengence. It's taken me two and a half years to pull up the courage to embark on this diet/lifestyle again. It can take a tremendous amount of commitment, planning, and resources, but quickly becomes a habit, and the results are sooooo worth it (try to avoid starting the diet during the holiday season... it's really tough to avoid all the treats. I ate some fruit and got a horrible detox rash on my belly). After the initial detox period, the diet is not hard to do, especially if you can wrap your head around Dr. Weston Price's nutritional principles. The slower you transition into the diet, the easier the intial detox will be on you (meaning no trips to the emergency-room with bizarre gastro-intestinal pain). If you drink soda or alcohol, be kind to yourself, and go really really slow. You have more work to do.

My hairpulling started at 18 when I went on birth control pills. my hair fell out in clumps when I ran my fingers through it, and then I just started to coax it out, which developed into trichotillomania. I was on other meds for ADD and depression at the time, as well as having used a copper-based shampoo/conditioner for many years (gave me a weird scalp rash occasionally). I was also living in a moldy dorm room. Never in my life had I pulled out my hair prior to this time, and the bcp seemed to be the catalyst.

Just for comparison, I want to list all the other treatment options I've invested in over the years, which haven't worked: two years of lenient vegetarianism, half a year of veganism, another half a year of raw foodism, 5 years of brain meds, two years of behavioral therapy, 6 years of psychotherapy, two years of neurofeedback, 4 months of neural therapy for tonsils (to treat PANDAS... worked for other stuff, did not help hairpulling), anti-fungal shampoos and coconut oil on the scalp, NAC, TTO, ALA (worsened hairpulling... mercury yeast connection??), sugar, alcohol, kefir and sourdough (Yeasts!)

PANDAS Theory has some weight to it (strep caused tic disorders), but is not the whole picture (for me at least). I probably had varying degrees of Pandas through out childhood, and I'm almost positive that it has been partially responsible for me acting to the bcp's the way I did... Gargling with salt water can help control the urge to pull sometimes, depending on how much sugar I've consumed.

I embarked on the no-carb diet in late october and was completely hairpull-free within two days (before starting on antifungals). After 8 years (give or take)of daily pulling, that is nothing short of a miracle.

So, to recap, hairpulling, for me, seems to be related to a fungal issue on the scalp and elsewhere within the body... google "John Kender and fungus" to see an "experts" view on the issue.(I'm 26... started pulling at 18.)

I hope this isn't too much oversharing, and that it helps someone!

N-Acetyl Cysteine
Posted by Bee (Anon, Usa) on 12/07/2009
★★★★☆

Just wanted to update on my progress with the NAC and Trichotillomania. I have been taking a dose of 1200 mg for just short of four weeks (the studies I read said best results were at 9 weeks). I am obviously not cured and still have some bad episodes of pulling. But it's worked well enough that I finally have some eyelashes growing back- and this is for me BIG progress. It's hard to see progress with this disorder because you can feel like your progress is completely ruined with one bad episode of pulling and you are back to square one- but I'm trying to realize it's not that big of a deal and it's not all ruined. I do have less strong of an urge to pull which is a new feeling and I assume it's the NAC since I haven't changed anything else. For most people this is a lifelong problem, so to see any progress makes me happy- I am going to continue on with the NAC and may even increase the dosage to 2400 mg- depending on progress further along.

N-Acetyl Cysteine
Posted by Bee (Anonymous, Usa) on 11/08/2009

I decided to go ahead and purchase some N-Acetyl Cysteine- it's being shipped now. I purchased 600 mg capsules and will start on a regimen when I receive them. Will update with my progress- I really hope for good results since I have struggled with TTM since I was very young!! You don't find too many people out there that want to talk about this problem either- I admit I'm quite ashamed and embarrassed by it myself. Thanks again for this great website!!


N-Acetyl Cysteine
Posted by Bee (Usa) on 10/29/2009

I had posted asking about this not too long ago. The studies I read on pubmed had said dosages were from 1200-2400 mg. I have not yet tried it- but am seriously considering it- I would love to find a solution to this problem- sometimes I feel so defeated with this disorder- most people just wonder why I don't just stop pulling- but it's so much deeper than that- even on days I say I won't- inevitably it happens- next thing you know my eyelashes and eyebrows are bare. It's horribly frustrating and embarrassing. I would love to find something to help.


N-Acetyl Cysteine
Posted by Ch (Pdl, United States) on 10/28/2009

This is a very interesting thing on hair pulling, It was saying in a study done at the University of Mennesota. They gave half a group N Acetyl Cysteine and half a group placibo, and the half that took the N Acetyl Cysteine after 9 weeks of treatment dramatically reduced and was able to put the breaks on pulling their hair, the only thing they did not say was how much of the N Acetyl Cysteine that they took in the study. anyway this is where you can watch that video www.youtube.com/watch?v=yIrh4yd4Nus

Apple Cider Vinegar
Posted by Angela (Nashville, TN) on 08/27/2007
★★★★★

I originally found your website after I did a search for treating my reoccurring sinus infections. I began to take the ACV for a lingering cough after a sinus infection that just wouldn't go away. Immediately I felt like I could breathe better and I began to cough up the mucus in my chest. After a couple of days I noticed something else had changed about me. I've pulled hair out of my head for approximately 25 years and I hadn't pulled my hair out during those two or three days that I had been taking the ACV. It was so far from my mind that I didn't even realize I wasn't doing it! I then began to wonder if it was the ACV and I remembered a few years ago an article written by a man who's daughter suffered from hairpulling. He did some research and believed it was due to her scalp having dermititis...which is a fungus. I started to think that the ACV was getting rid of the fungus on my head, causing me not to pull. I am writing to you today to let you know that it's been three weeks since I've pulled a hair out of my head! This is amazing! I've never gone this long in my life without pulling out my hair, I'm so thrilled. Thank you so much for this miracle cure.


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