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September 2010

The Band-Aid Sign of Trichotillomania: A Helpful Diagnostic Technique in the Setting of Hair Loss

Author Affiliations

Author Affiliations: University of Texas–Southwestern Medical School, Dallas (Ms Prather); Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (Dr Kundu); and Ronald O. Perelman Department of Dermatology, New York University Medical Center, New York (Drs Kundu and Mahlberg).

Arch Dermatol. 2010;146(9):1052-1053. doi:10.1001/archdermatol.2010.230

Indeed I think that the men who pluck out their hairs do what they do without knowing what they do.

Epictetus, The Discourses, 3:1, 101 AD

Historically, self-inflicted hair loss, or trichotillomania, was first recognized and named by François Henri Hallopeau, a French dermatologist who combined 3 Greek words to describe this condition: thrix (hair), tillein (pulling), and mania (madness).1 Patients with trichotillomania, a neuropsychiatric disorder classified by Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria, are not always cognizant of their hair-pulling habits and may seek a medical “cure” from dermatologists. Clinic visits can be difficult and lengthy while the physician tries to obtain the history, confirm the diagnosis, and convince the patient of the underlying psychiatric disorder. We report herein a case demonstrating a practical method to confirm the diagnosis of trichotillomania and help the patient understand the extrinsic nature of this condition.