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How to Style Your Hair If You Suffer from Hair-Pulling

Trichotillomania is a rare impulse disorder.
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Q: Hi Bill! I am a huge fan of your consultations and I have no doubt you will give me some great advice.

I'm 17 years old and I have a rare impulse disorder called trichotillomania, which causes me to pull out my own hair. I've had it for over two years now, and I am struggling to fight and overcome my disorder.

I pull hair from my scalp (thankfully not my eyelashes or eyebrows, which I believe is much harder to hide), but it's in such a bad way that the constant pulling has left me with patches. The good news is that as I'm trying harder everyday not to pull, these patches are growing back. (Yay for no permanent damage!) These pieces are around my crown, and stick up in such a way that I cannot even style my hair down anymore—which is heartbreaking because that makes me feel pretty and is something I believe I'm actually quite good at.

This has left me feeling ugly and unfeminine, and it deteriorates my self-esteem as I try to clip up my hair in ways that won't let people see my patches and re-growth. As I can't wear my hair down 'til it grows back, I wear it up in a messy sort of bun thing, which is fine, but getting a tad boring. I'm surrounded by my beautiful friends with gorgeous, long hair, and I hope to one day grow my hair back. I had long, shiny brown hair that I was proud of, and I'd do anything to get my hair back to health and try make it look better again.

About my hair history: I started colouring it when I was 14, but it is now almost all grown out, and the hair I have is actually in quite good condition. I regularly give myself oil massages to encourage some growth, and I no longer heat-style my hair. Do you have any suggestions as to how I should cut it or how I should wear it up?

Thanks in advance! Xxx — Hannah

A: Hannah, thank you for coming forward and talking openly about hair loss.

When I was younger, I pulled out some of my eyelash and eyebrow hairs, thinking it felt cool. I did not keep that up because I noticed my father did not have much in the way of eyebrows as he got older. I grew up on a farm in the 1960s, and there was little to no obvious male grooming going on. If farmers did not go to the barber to trim those long eyebrow hairs, they would just pull them out—which created a balding effect. (An effect that I did not want, because I was vain from an early age.) So I focused my pulling on my unibrow that was settling in, and now no longer need to pull.

I'm assuming you are on a holiday from pulling, since you currently do have hair growth. Right on, because it looks like you have a really pretty head of hair!

As it grows in, you will see what a lovely colour you have as well, so please don't miss out on that. Try not to colour again, but if you have to, try to do as much off-scalp colouring that you can. The healthier for your scalp, the healthier your hair.

Any stimulation the scalp gets will help improve the blood flow, which in turn helps hair growth. So if it is oil you use as a conduit, then oil it is; all hair and scalp types need different attention. Stimulation is the name of this game to get hair growing.

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From The Skincare Edit Archives

A low caloric intake also has its place in hair loss. I'm going to say it… red meat is your nails' and hair's best friend. Sorry, I believe it to be true.

The way you've been wearing your hair up seems to be the best way to deal with it as it is. You are so pretty that the casual, sloppy bun has a certain cachet that most people cannot pull off.

Julianne Hough's messy bun.

People with any sort of hair loss—whether it be from stress, illness, alopecia, trichotillomania or any other reasons, including age—will have strategies that work for their particular situation. Coverage is most people's issue, so it depends on where your particular problematic areas are. Nobody likes a comb-over hairstyle, which can be tricky to avoid in some situations.

It is best to treat each section of your hairstyle as a style detail. Depending on where your coverage issues lie, the sides can be worn either tight or loose...

Jessica Chastain at the 2012 Oscars.

The back either up or down...

Ashley Benson at the 2011 TV Guide Hot List party.

And the fringe with a bump going back or a flat side-sweep forward... 

Emma Stone at Trevor Live in 2010.

These details are for every style, with or without any hair-loss complications.


Bill Angst is one of Canada’s top celebrity hairstylists and the owner of Angst Salon at 240 Queen Street East in Toronto. Call 416-360-5942 to book an appointment.