The hair loss and extension expert Lucinda Ellery has just launched ‘National No Pulling Week’ which aims to raise awareness for a condition that not many of us have probably heard of, but it is a lot of common than you may realise and is deeply distressing for those who suffer from it. The condition in question is ‘Trichotillomania’ (TTM) and you can be forgiven for not knowing what exactly it is. Trichotillomania is hair loss resulting from a long-term psychological condition which results in the sufferer having repeated compulsive urges to pull their own hair out, whether this is their eyelashes, eyebrows, or more commonly – on their head. Symptoms typically begin during adolescence, before the age of 17 and usually include; repeated tugging, pulling, or twisting of hair, uneven appearance to hair, a denial of pulling out any hair, strong tension before pulling out the hair and then a huge sense of relief after doing it. It is an extremely addictive yet debilitating disorder which may not make the sufferer psychically unwell, it can have destructive social and emotional repercussions. Specific causes for the condition have been difficult for health experts to ascertain but it is believed to be triggered by stress, anxiety and depression. Some scientists have even delved a little further into the reasons for the condition and blame defects in genetics. In particularly one study found that mice with a mutation to their protein ‘HOXB8’ gene showed strange behavioural traits which actually included hair pulling. Remarkably this rarely-discussed genuine health problem affects about 4% of the UK population during the course of their lives, equating to one million people! To further stress just how common Trichotillomania is, estimates show that every GP will have about 10 patients with TTM within a list of about 1,000 people. One of these sufferers is a 32-year-old mother of one named Zena Williams. Zena first began tearing out the hair from her head at age 11 during a class at school, where she says she entered into a strange ‘trance’. Before she knew it, her class work book was covered in the hair she had pulled out. Over the course of the summer holidays after this, things got worse. Zena was pulling and plucking on almost a daily basis, leaving her with a large bald patch on the top of her head. She then started to wear a baseball cap in an attempt to hide the damage from her own mother; however this plan didn’t fool her mum who eventually noticed the bald patch and took Zena to a doctor, who then misdiagnosed it as alopecia. Upon her return to school, Zena was now sporting a wig in an attempt to hide the bald patches from her classmates, leading to torment from cruel bullies. I was mortified about going to school wearing a wig but I didn’t want anyone to see what was underneath. People would point out that my hair didn’t look real and I tried to shy away from their comments. A couple of girls started bringing a camera to school in order to take pictures of me while I was sat in the playground. The cancer rumour started around the same time and I remember being cornered while a group of them taunted me, calling me ‘cancer face’. It was horrible.” Zena’s bullying lasted throughout the duration of school and after this point she grew a levelled inch of hair all over her head and ditched her wig. However in resisting the desire to pull the hair out, Zena still battled with psychological problems and subsequently turned to self-harming with scissors, knives and compasses. The urge to pull her hair out was unfortunately still there at age 18 when she moved out of the family home to live with her boyfriend and things got worse when she split up with him. She says, “When I split up with my boyfriend it got so much worse and I would have to hide it from everyone. The only time I've ever managed to stop pulling was when I was pregnant. I felt so ill throughout the pregnancy I literally didn't have the time to think about it. When my daughter was born was the only time since I was 11 when I've had a full head of hair.” After hiding her secret obsession from everybody for two decades, Zena happened to click onto a YouTube video made by a young girl who was suffering with the same condition and was pulling out her own hair too. Zena couldn’t believe that the mental anguish she had suffered all this time actually had a name to it and was a genuine health condition, not just her own personal, peculiar problem. She comments, “My condition was a real thing with a name and I just burst into tears to discover there were others out there like me. Until that point I had always believed it was this disgusting thing that only I did and that no one could ever possibly understand.” Nowadays Zena’s condition has greatly improved since she gave birth to her daughter, but still admits to occasionally pulling out hair on her arms and legs. The years she spent tearing out her hair have also resulted in damaged follicles in her scalp and have left bald patches on her head, now dying her hair black and scraping it back in an effort to hide the patches. However, she has found comfort through speaking to fellow sufferers on social networking websites and currently sits on a waiting list to receive cognitive behavioural therapy, which she hopes will finally banish her demons forever. When asked, leading UK Trichologist David Bailey said, “I came across my first Trichotillomania case over 30 years ago. I was shocked to see a large area of hair missing to the left hand side of this female patient’s head. I knew what it was because of my training, but the patient refused to admit she was self-harming by pulling her own hair out. I asked her if she was left handed to which she admitted, which is a good indicator, as they always use their preferred hand to pull the hair out. Since then, I have seen numerous Trichotillomania patients, some left handed and some right handed. They all appear not to realise or admit that they are self-harmers, and in my opinion need some sort of psychological help to try and resolve the problem.”