Trivial Hirsute
SINCE ANCIENT TIMES, “tearing the hair” has been a
sign of anxiety, anguish or suffering. In the paintings of the old masters, this
wrenching of the hair of the head has long been an icon to convey mental
suffering, depth of misery and desolation.
Around the year 457 B.C., the biblical figure, Ezra, was beside himself with
despair when he learned that many of the Israelites then in Jerusalem were
married to women from heathen nations. “When I heard this thing,” said Ezra,
“I rent my garment and my mantle, and plucked off the hair of my head and of
my beard, and sat down astonied (amazed).”
Plucking out the hair, one strand at a time, is an exquisitely painful procedure
that would be an act of self-mortification required only on occasions of
especially deep sorrow or distress. On the other hand, clipping or shaving the
hair of the head and beard, especially during periods of mourning, is frequently
mentioned in sacred writings and was common among all ancient nations.
Herodotus, circa 400 B.C., speaks of hair-pulling as a familiar practice for
most men, except the Eygptians. A good 200 years earlier, Jeremiah had commanded
men in mourning to “Cut off thy hair . . . cast it away, and take up a
lamentation.” For funerals there were professional mourners who could be hired
to wail and cry and symbolically tear out their hair, as is still the custom in
some societies today.
Many people twist, rend, tug, pull, tear, or rake their fingers through their
hair when they are having trouble working out a mental problem or when they are
under unusual stress. “I was so mad, I was tearing my hair out,” is a
hackneyed phrase in use nowadays to illustrate the degree of frustration we have
experienced in a particularly difficult situation.
Sometimes the common habit of fidgeting with the hair leads to an excessive
tearing of the hair and the complete denuding of some body areas. At this point
the condition becomes a medical problem.
Nineteenth century doctors thought the morbid impulse to tear out one’s own
hair was “a habit developed by highly neurotic or insane persons.” Thus, in
1889, a French dermatologist by the name of Hallopeau used the term
trichotillomania (tricho- hair + tillein to pull + mania to
be mad) to describe the case of a young male patient who had torn out large
patches of hair on his scalp.
Trichotillomania typically starts either in early childhood, before the age of
6, or during young adulthood, from the age of 12 or 13 to the early 20s. In the
younger group, boys and girls are affected about equally, but most of those who
are affected in their teens are female.
The hair-pulling is most likely to occur during sedentary activities, most
frequently when subjects are watching television or reading. Researchers have
also discovered that over half the people who suffer from trichotillomania pull
out their hair only when they are alone.
The most common body site affected by the disorder is the scalp, followed by
eyebrows, eyelashes, facial hair, the forearms, body hair generally and pubic
hair specifically. The damage caused by the repetitive hair-pulling can range
from small, barely noticeable patches to total baldness. The dramatic change in
the sufferer’s appearance frequently leads to emotional disturbance, social
isolation and a severely limited lifestyle.
An exhaustive study of the disease in 1987, involving 2,579 college students,
found that hair-pulling may not simply stop with actual removal. A whole range
of activities involving the manipulation of the hair often takes place,
including stroking the hair against the mouth or face, examining the hair, and
playing with it.
A majority of the patients, after pulling the hair out, rub the hair around
their mouth, chew or bite off the ends of the hairs, or lick them. A small
percentage of them will actually eat the hair (trichophagia), a condition that
can lead to development of rare but life-threatening gastrointestinal
obstructions known as trichobezoars (hair-balls).
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