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This is a disorder, what is the recommended course of action and how effective is it in treating this disorder?
Go visit a psychiatrist. This thing is a symptom of a few disorders and probably shouldn't be treated alone.
Replacements are helpful, try a bunch of different things to see if you can find something that soothes you in the same way. I tried silly puddy, pulling the bristles on a brush, stress balls, many different types of "fidget toys" that snap together or you can manipulate.

My biggest problem was boredom while driving and the thing that felt the best to me was pulling apart a certain type of sponge. I make a little mess on long car rides but it's better then hurting myself.

I have been recommended Cognitive Behavior Therapy (CBT) to treat my trich. I'm also on prozac but no matter the dose it doesn't really seem to help as much. I haven't made my first appointment with my therapist yet so I don't know how well CBT will help me personally, but I have heard that it helps with things like trich as well as OCD (which I have as well)
I basically do the same with my beard within the chin… I usually pick those "not perfect" and also those who are grown slightly longer than their neighbors…
I have also started doing this with my beard from my high-school years. As in the article, there are "special" hairs that you feel a need to pull out and offer some strange pleasant feeling.

I forced my self to stop several times for a few months, but in times when I am stressed or less mindful I do it again -_-

I've started shaving myself regularly to stop myself from doing this.
I'm right there with you. I am sooo glad it is just my beard and not the hair on my head. My beard I can keep short so it doesn't become much of a problem, although occassionally I am a bit sad that I will never attain that true lisp hacker look.
I do the same with picking certain spots on my scalp and have done so ever since I was abbot ten or so. They just feel bumpy and not smooth and I feel like I have to smooth them. Of course, it only makes things worse. In reality, they look no different than the rest of the scalp. After I had chicken pox the bad habit never went away. At one point I was also picking my arms. Until this year, I never talked to anyone about it and thought of it as some sort of ridiculous addiction. At times I have managed to get it under control. The longer I go without it the easier it is. It's freeing to be able to talk about it in real life and here after over thirty years of denial and secrecy. The turning point for me was reading an article about it and realizing it is a disease, similar to OCD which I likely also have, and that I'm not crazy or messed up in a unique way. Thanks for listening and to others who share their own stories of this affliction.
I tend to do the same, picking at uneven feeling bits. What sucks is how it turns into a vicious cycle. If I can somehow keep away long enough for the skin to heal, I can usually stop.

Until I find another spot.

Fuck, this isn't normal?

This is like when I discovered that my tinnitus isn't normal, and that most people don't have an incessant ringing in their ears.

Luckily, like the writer of this blog post, it isn't really noticeable on my head (my hair is already quite thin), which is why I've never realise it's not normal.

Wait, you thought a persistent ringing noise in ears is a normal human trait?
I guess so?

My father has it too (and my grandfather had shit hearing), so I think it's in part hereditary. Years of construction work with power tools and target shooting (often without hearing protection) hasn't helped though.

I've had tinnitus since as long as I can remember. It doesn't bother me, I usually don't even notice it unless I'm specifically thinking about it. I've had it so long that I don't actually have a baseline of what true silence is, my brain usually just filters it out (although depressive episodes and drinking often bring it out).

I've read stories about people who've been driven mad by their tinnitus. Thankfully it barely affects my life. Like, now that I'm thinking about it, I can hear it above everything, but when I wake up in the morning I'll forget I have it.

Spent many years of my youth chasing loud hardcore shows. I remember distinctly the show that left me with ringing for two weeks, that mercifully subsided. From then on I wear plugs, even when doing things like mowing the lawn.

Protect your ears man.

Hey, me, too! Since I was way too young to attend my first rock show or hold an air tool. Doesn’t bother me a lick because, well, that’s apparently the way I was built. Like you, I don’t even notice unless I think about it. Can’t say about the rest of my family, never asked.

I’ve always wanted to go to one of those acoustically-dead rooms, where you can hear the blood pumping through your veins. Or will I?

Being in a room so quiet you can hear your own bloodflow drives me insane. It gets louder, and louder, and louder ...

Give me just a bit of actual noise to hear, please and thank you.

Also having tinnitus since birth (or very young age), it's the kind of thing you don't question.

Similar to how some people in need of glasses never go to the optometrist because they think that seeing blurry is normal. Or colorblind individuals that are not aware that not everyone sees life in two colors.

I also had floaters in my visions for ages before being told that not everyone has those... and visual snow / static even in daylight, which it turns out not everyone has.

Damn, my body's sensors are so defective.

Are we limiting this to early childhood before you know better? I can't see someone going through their life thinking they shouldn't be able to see properly, or have shit floating around in their eyes(I have had both since birth). I mean common sense says that's now how things are supposed to operate.
How does common sense say that? Talking to other people about how they perceive the world is what would say that, but that doesn’t necessarily happen.
If it happens gradually you might not notice until it's really bad. I know someone who got new [+] corneas and cried when they realized they could see individual pine needles on trees. They'd just forgotten that that was a normal thing they could do.

[+] Well, slightly used lol

I can definitely relate to that; after laser surgery (and I mean literally minutes after) I could see the wood grain on the window sill in the darkened room they put me in post op. On the drive home I could see leaves on the trees in the most fabulous definition. I knew my vision was rubbish, but to have it hammered home so starkly was literally eye opening. I marvel at it to this day and I advocate for people getting laser surgery so enthusiastically you'd think I was on their payroll.
I rarely compare body specs with others. Maybe there's a bunch of other stuff that are weird about me.

For all I know there's something wrong with my sense of touch or smell. I never smelled a flower and then proceeded to ask the person next to me "do this smells like X to you?"

Take cilantro as an example. For 5 to 15% if the population, it tastes just like soap. I am sure that a lot of people think that it tastes soapy for everyone else.

Plenty of people have oddball things going on with their senses that they aren't conscious of. I knew one guy who wasn't aware of his colorblindness until he owned some navy and some black socks that were otherwise identical, which occasionally had humorous results, and another guy who couldn't get into the AF academy because of a similar problem (much less funny).

Being unaware of a problem with hearing is similarly easy. If a problem doesn't cause physical pain, doesn't have any real-world consequences, and doesn't physically manifest full-strength all at once, the brain can do a lot to keep us from noticing the existence or the progression of the problem.

Wait, you think if you had been born with tinnitus you would have just intuited the fact that it wasn't normal and others couldn't hear it? I don't think you put a lot of thought into your response.
I think most people have enough intelligence to realize something is wrong. Why go to the doctors at all then? Surely my problems must be normal for humans. Sure, as a young child you'd not think about it. But as an adult, you're telling me you wouldn't question that? Come on.
Sure, perhaps if you tinnitus is the sound of a plane landing. But for a faint constant tone that your brain filters out unless you are in total silence? Why go to the doctor at all?
>Why go to the doctors at all then?

Many people do in fact not seek medical attention for problems they have had for very long amounts of time. People are quite adaptable. If you have grown up with some peculiar trait that nobody else has it is not so easy to notice that something is off as we learn to work around it seamlessly, the same is often true in people who suffer from depression, it can be easy to just accept it as the normal state of affairs.

I also doubt that this is related to intelligence. On the contrary, it often seems that people with high aptitude have a particular talent for rationalising conditions that set them apart from others. This, for example, shows up in certain political biases, where higher education among some groups correlates with worse understanding about facts. (https://www.nytimes.com/interactive/2017/11/14/upshot/climat...)

My own experience is that I would do this (specifically pull the hair from the back of my head behind my ear causing a bald patch) whenever I'm stressed or feeling particularly anxious... the latter part being fairly often. However I found that the trichotillomania stops if I cut my hair very short with clippers and so now this is my hair style. Thank god I'm a bloke.
I'm the same way. It is interesting though, because when I would cut my hair shorter my mind somehow knew the second that my hair was long enough to be pulled because I would start up again. I also grew my hair out pretty long (for me at least, maybe 2 or 3 inches long) and would twist my hair to knot it up and then pull on the knots. It would cause pain but it the pain felt so good. Similar to when I pull my hair and I have cuts on my fingers (typically from when I pick the skin near my finger nails). The pain of the hair running over the nails is so satisfying.
Im the exact opposite. I pull my beard and when I shave, I still have the urge to pull except the hair is shorter now and I have to work harder to pull it out. I continue to pick and pluck at it with my fingernails until I damage the skin and it gets swollen.
I do this too. Particularly when I'm reading something online or thinking. I was smoothing my sideburns whilst reading this post, looking for "that special hair". I favour my sideburns and beard.
Heh, I was just doing it with my eyebrow. Noticed a harder, thicker hair among the softer hairs. Pulled out five other hairs before getting it. Probably have a hole in my brow now.
When I was young I’d wrap my hair around my finger and pull out giant chunks. My parents would tell me to stop, so I just began hiding the hair in vases and stuff lol. I stopped eventually, no idea why I started doing it.
> Others are skin picking and cheek or lip biting.

Cheek and lip biting isn't normal? I mean just kinda gently chewing on the inside of your cheeks/lips while you're thinking.

It probably feels normal to many people, but damaging yourself while nervous or distracted, even a little, isn't really healthy.

That isn't to say I don't do it. But when I do, I recognize that I shouldn't be.

I developed this habit for a few years during adolescence, which I think was a reaction to the anxiety that developed at that time of life, relating to things like social pressures, academic challenges and parental expectations.

I can recall visiting the bathroom multiple times per evening to find new hairs to pluck out of a particular area on the side of my face, as a form of procrastination and distraction from stresses I was feeling.

I think it stopped when I finished high school, and I haven't exhibited this particular habit ever since.

However, it was in the year after I finished high school (1995) that the internet started becoming a thing, and I jumped on board quickly and developed the habit of frequently checking things (news sites, and, ahem, discussion boards) online.

I can't help but ponder that if it weren't for having a phone in my pocket and being able to reach in and check Twitter or HN every time I needed a dopamine hit or a distraction from anxiety, I might instead be carrying tweezers in my pocket and plucking hairs every hour or two :)

My wife used to do this shit nonstop for years - drove me crazy. She seems to have stopped since having a baby - reason being too busy?
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With respect, "this shit" and "drove ME crazy" don't sound all that empathetic. This is a disorder that people can't help, and are often very embarrassed by. I think the right way to handle it is to be supportive in trying to help get treatment, while making clear it has zero impact on how you view them as a person.

Not saying you're not doing that, but just a good reminder. I have someone close to me that suffers from this (and is embarrassed by it) and it's helped both of us to sort of view it as a biological quirk/defect (like wearing glasses) vs something really shameful.

With respect, the full quote included the word "nonstop". Someone with OCD-like behaviour can drive you crazy. My partner has autism like I do (and my autism drives her crazy, at times, though I also omit e.g. picking my nose around her), and she's on a witchhunt with certain things such as pimples on my and her body (even though its less painful if I do it myself), dark (small) hairs on her chin/legs (she's brunette), the few hours which form a vague unibrow on me, hair on our ears. I get it if the reason is ingrown hairs, I really do. But the other stuff seems over the top. She also has a plethora of cleaning and hygiene rules which might make sense but are outliers (for example the cats are exempt). I can totally imagine someone who's going through such can sometimes use harsh words to vent their frustration. It isn't chique, I agree.
I do this and it drives my wife crazy. The kicker is that she finds it relaxing when I play with her hair and she is ok if I do that but not when I do it to myself.
Having a baby can have significant biological impact on the mother. It can have all kinds of fallout.
I went through some very traumatic experiences during my sophomore year of high school. I can't say 100% that it "started" my trich, but within that same year, I began pulling coarse/kinky black hairs from my head because I felt like they were out of place. I was fascinated by their presence among all my blonde hair. Moving into college I started targeting other more subtle areas like sideburns and my beard. I found that I could pull on these areas in the middle of class without drawing much attention to myself. Back in the privacy of my dorm room, I would pull pubic hairs to relieve the stress I felt while racking my brain over challenging math problems (I was a math major). During this same time, I also developed an addiction to pornography.

Fast forward, I just had my 33rd birthday. I haven't looked at pornography in over 5 years. But I'm still struggling with pulling out my hair. And that's how I know how much of a stronghold this has on my life. I do it mainly when I'm self-soothing or just under a lot of stress. I know my triggers and I still can't defeat this thing. I have tried N-acetylcysteine, shaving my hair short, prayer. My wife will even swat my hand down (bless her heart) if she sees me reaching for a hair. But then I end up getting mad at her for not letting me have my fix.

My theory is that I don't truly value and love myself and that's why I'm willing to inflict damage upon myself. Sometimes I even use pulling to "punish" myself for not understanding technical things. It's self-mutilating and there is a lot of shame and guilt associated with it.

I'm still hopeful that one day I can overcome this habit (disorder?). I sure as hell don't want to have kids and have them grow up watching daddy pull hairs.

Have you tried redirecting the habit? While changing at the core is ultimately the goal, redirecting actions into a set of more neutral ones might help. For example, having a bracelet that you can play with, or even in some cases pull on to feel it snap back in place.

It's very hard to redirect all the activity that our mind produces at all times, I have very similar issues and I understand that too.

I pick at my facial hair whenever I'm reading or thinking, it's a big problem for me since I like having a beard. I have to shave it every so often because it gets scraggly with bald patches of plucked hair. Thankfully growing facial hair is my super power so I typical have a full beard again soon enough.. only to start the cycle all over again. When I shave it off I'll pluck at my eyebrows instead which take longer to grow back and patchy eyebrows look more weird (to me) than a patchy beard.

I've tried all sorts of ways to stop but the activity is sub conscious and by the time I'm aware of it its too late.

If you wanna break unwanted habits you have to break bad neural paths and force your body to develop the new neural connections.

Try to scratch your beard gently, caress a cat, etc. Lace your shoes differently, switch from one loop wrap to bunny ears. Since I watched "Dealt" movie I've been shuffling a deck of cards while reading from screen, it feels very comforting.

You have to foster these good habits the hard way, through repetitions. Don't be hard on yourself plucking hairs or skin picking has occurred once again, but praise yourself for how much of a cat lover or agile deck shuffler you are.

That's a great way to quit a lot of bad habits including smoking. When you feel the urge to smoke or vape, take that energy and use your hand on something positive such as a quick workout, cleaning parts of your home, etc.

You can try to smoke and workout at the same time but that'll just likely make you sick and vomit. heh

I've been picking my beard every since I was a teenager. I do it when I'm thinking about a coding problem so my desk is full of little hairs at the end of the day. I also did it during driving long distances and when watching television.

I think it's related to stress and when I have nothing to do with my hands. This is not happening when being active outside in nature.

I've noticed that I'v actually started touching and searching for hairs in my beard while thinking about this next sentence...

When I search for a hair with my fingers and found one I can find that particular hair without looking, I know what it feels like, where it is and it has to come out. I keep picking until it's gone. Sometimes I throw it away, sometimes I put the hair softly against my lips, the lips are very sensitive and able to feel the shape of a single hair.

Shaving helps for a bit, but a couple days later it's the worst because all the hairs have the perfect length... Just long enough to find, just short enough so it's a challenge to grab them.

Sometimes I close my eyes to really focus on the feeling of the fingers and concentrate on grabbing that hair.

Sometimes I use both hands, one to grab the skin and make the hair go up a little bit so it's easier to grab.

My partner gets mad on me when I do it, but none of my colleagues ever said anything about but I'm sure they noticed.

It's definitely a disorder and very hard to stop by yourself.

While thinking of a closing remark I picked another hair, I guess that speaks for itself.

Yeah I decided to grow my beard out into a full one my freshman year of college and I got in the habit of picking at it. Very often I ended up with a big pile of hairs in my dorm that I'd have to sweep up. I've since shaved to a much smaller, cleaner beard and I can notice a few patches that I'm almost certain are from picking. I'm really hoping they eventually fill in. It's been several month since I shaved to a much thinner beard.
I started pulling out my beard hairs as a replacement to cheek biting, which was a replacement to nail biting... Now I try to make sure I just keep a pack of gum on me.
I do this, but not out of compulsion or stress; I do it out of specific irritants: ingrown hairs.

Oftentimes a beard hair will grow into my skin and I will unconsciously pick at non-ingrown hairs in the general region until there is a small hairless hole surrounding the actual ingrown hair.

I have to consciously tell myself to get a needle and fish it out preemptively so that this doesn't happen.

I admit I plucked out a few gray hairs when they first started showing up, but I mostly leave it alone.
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It's odd seeing so many people here confirming they have trich. Ive never even seen someone pull their hair and it's pretty obvious as someone who does it. Although I did see this girl on a bus one time picking at her scalp but that's probably just dandruff/psoriasis because I have psoriasis too.

I pick my beard hair. I think I've damaged the hair follicles because I pick exclusively with my left hand and so I pull the left side of my beard. Only the left side cant grow hair anymore but the right side is fine.

It definitely happens in "binges". Only when I'm anxious about something, whether a work problem or some other issue that I worry about. Just yesterday, I looked down on my white desk at work an saw hairs littered all over the desk. Didnt even notice I was doing it. I can go months without doing it and then suddenly go back to doing it.

I shave frequently but it makes it worse. I'll find a hair that is "just right" to pick and it'll be too short to pull with my fingernails so I'll pick and pick and pick until the skin around the hair gets swollen and the hair "sinks in" making it even harder to pull. It's a terrible feeling not being able to pull it out. Like chewing food and then spitting it out instead of swallowing it. Like eating all of your food and then leaving exactly one last bite. Like masturbating but not finishing.

I do have a range of other mental problems including chronic depression and bipolar disorder (mild) but not many other "ocd" habits. The human body is weird.