Racial identity may affect impact of trichotillomania on black women: pulling hair from scalp, pubic region.(Clinical Rounds)

CHICAGO -- Trichotillomania among African American women often involves pulling of the pubic hair as well as pulling of hair from the scalp, eyelashes, or eyebrows, which may add to the profound sense of shame patients feel, Angela Neal-Barnett, Ph.D., reported.

The compulsive pulling out of hair is a poorly understood phenomenon, with debate still raging over whether it is an anxiety disorder or a habit disorder. A review of the literature shows a dearth of good epidemiologic studies describing the disorder in any population, she said at an international symposium sponsored by L'Oreal Institute for Ethnic Hair and Skin Research.

Dr. Neal-Barnett does not know whether trichotillomania is more common in African Americans than in other ethnic groups, she said in an interview, "but I do believe it is more hidden."

The pulling of pubic hair had been noted in previous studies, but in Dr. Neal-Barnett's extensive interviews and psychological testing of 41 African American women from the United States, France, the Netherlands, and South Africa, it became clear that the pulling of hair from more than one body site is a common experience among this group.

The third most frequent body site for pulling hair was the pubic region, behind the scalp and eyelashes, said Dr. Neal-Barnett, a psychologist from Kent (Ohio) State University.

Fourteen subjects pulled hair from the eyelashes and pubic area, 11 from the scalp and pubic area, and 5 from the eyebrows ...