Trichotillomania and Pubic Hair Pulling

By nature trichotillomania already causes the sufferer great shame and embarrassment, especially when there is noticeable hair loss. But what happens when the behaviour is focussed in the pubic region? While this may be easier to hide, it is also the most under reported symptom of compulsive hair pulling due to the extremely private and shameful nature of the behaviour. While trichotillomania and other body-focussed repetitive behaviours (BFRBs) are gaining momentum in awareness from the increasing number of people speaking out about their experiences with this condition, those who pick in the pubic region remain hidden in the dark.

More common than we realise

Anonymous self report studies often reveal surprising statistics around the prevalence of more embarrassing conditions because the respondents are able to hide behind their anonymity. One internet-based study found that from a sample of 860, 50.7% reported pulling pubic hair within the 2 week research period. This is in contrast to earlier reports from face-to-face data collection studies which suggest that pubic hair pulling is relatively uncommon. Another interesting study found that patients who pulled pubic hair were more likely to present with comorbid lifetime obsessive compulsive disorder (OCD), and had an earlier age of onset of hair pulling compared to those who did not pull pubic hair.

You are not the only one!

When reading the numerous discussion boards and support forums it is clear that trichotillomania manifests in a diverse number of ways and that the experience is unique to each individual. But it also highlights the fact that compulsive hair pulling in which ever form is occurs is rife and that people who are suffering with trichotillomania are not alone. There are some courageous individuals who take a leap of faith into cyberspace and openly describe their pubic hair pulling, earnestly seeking advice and support to overcome this intensely personal and embarrassing behaviour.

One forum poster on a site dedicated to all things mental health had this to say about pubic hair pulling:

“I am extremely embarrassed to be posting about this, so I'd really appreciate it if nobody called me gross as I already feel disgusting enough… When I was 17, I started pulling hair with tweezers from my pubic area. I got very obsessive about it and would spend so much time pulling hairs that I would often make myself late to school because I physically couldn't stop. When I ran out of hair, I would start digging into the skin with the sharp tip of the tweezers to get at the hair growing beneath. I ended up with a lot of scabs, sore spots, ingrown hairs, and other various bumps. I really "liked" the uneven places of skin and I attacked those with tweezers too, making the problem worse. I think a lot of it had to do with stress because now that I'm no longer in school, the hair pulling is less severe, though still present.”

In another web confession, well known trich blogger and YouTube vlogger named BeckieO, who has been very open about all aspects of her hair pulling, revealed that she also struggled with pubic hair pulling. This straight-talking, dynamic young woman, who has been sharing her journey with trichotillomania to thousands of readers and YouTube viewers, took years to talk about pubic hair pulling. This further highlights just how difficult it is for people to talk about it. As BeckieO puts it, “If people react so harshly towards pulling head hair, then what about pubic hair?” She goes on to list the target areas of her pulling, including pubic hair right at the end adding, “…There I said it. I’ve been hinting towards this for a few years now, but never posted any footage of me saying it online.”

Importance of awareness and research!

The more awareness there is about how common pubic hair pulling is, the more people suffering with this behaviour will access the various treatment and support options available instead of suffering alone and in silence. One case example of this is of a 38-year-old woman who, after reading a newspaper article about hair pulling research realised she may have trichotillomania. Kathy had been pulling hair from her head and pubic areas since she was 12-years-old, but had never told anyone or sought professional help because she was so embarrassed by it. It was only when she read in the newspaper article that pubic hair pulling was quite common that she decided to go for a psychiatric assessment. By using habit reversal techniques, "Kathy was able to gradually control her impulses to pull, and over time, her hair began to grow back". There are numerous treatment options for trichotillomania in general. In cognitive behaviour therapy (CBT) in particular you will be required to gain a clear understanding of your pulling and work with your supporting therapist to find stimulus controls and competing responses to your pulling behaviours. If you are not open with your therapist about pubic hair pulling your therapist will not be in a position to support you in finding specific strategies that targets pulling in this region. As shameful as you might feel, talking about pubic hair pulling is key.