A question I often receive because I am very open about my trichotillomania on social media is: "Do you have any tips?" I sure do!
The purpose of this blog post is to keep a running list of every single management tool that has worked for me during my 23 years with trichotillomania. This will be a live blog post, meaning I will be updating it as I try new things and find that they work for me.
Before I jump into the list, I want to make it clear that these body-focused repetitive behavior (BFRB) management tools worked for me but that doesn't necessarily mean they will work for you. Although we may have the same disorder, it is still a unique experience to us. My best advice is this: try everything and see what works! If something doesn't end up working for you, that is okay! It's not a failure. BFRB management is all about trial and error. The fact that you're trying something new is a win in itself. Keep going. You got this.

Positive Self-Talk
This is the hardest BFRB management tool to implement and by far the most important. Negative self-talk fuels the trichotillomania cycle. It is a fact that you will pull more when you are tearing yourself down. Why? Because trichotillomania is a self-soothing behavior and because you are being mean to yourself, you are making it so you have to continue to self-soothe. You are self-soothing because of YOU!
Let me give you an example:
I pull out an eyelash. I look in the mirror. I say to myself, "Oh my gosh! Barbara! What have you done? Look at this horrible gap you've made. Ugh. You look so ugly! I can't believe you did this!" I feel ashamed. My stomach starts to knot. I reach up and pull another eyelash. I look in the mirror. I say to myself, "Again? You just made it worse! Everyone is going to notice!" I feel even worse. I reach up again. The cycle continues.
Here is what positive self-talk does:
I pull out an eyelash. I say to myself, "It's okay. This is a signal. What do I need right now?" I feel supported. I don't even feel the need to go look in the mirror. Instead, I answer the question I posed to myself and continue with my day. The cycle is broken.
Here are things that I say to myself whenever I find myself pulling:
What do I need right now?
It's okay
One hair is not the end of the world
You got this
You still got it! Still cute!
You're okay
You're safe
You're loved
Shake it off
Shower/Take a Bath
One of my biggest triggers is having dirty hair. My trichotillomania brain rationalizes pulling during that time because my hair is already dirty so what does it matter if it gets dirtier? I can run my fingers through my hair without worry. It truly is a recipe for disaster.
I know that washing my hair regularly (and styling—we will get to that later) helps me keep my hands out of my hair. My trichotillomania brain can't rationalize pulling because my hair is clean and beautiful looking. Why would I want to ruin that?
A remedy for a very intense pulling session? A shower/bath. When I find myself pulling a lot from the same area on my scalp, it becomes irritated and that irritation triggers me to pull more. When I am able to get my scalp wet and massage it in the shower, I make my entire scalp feel the same. It makes the sensation go away.
Ask for Support
Trichotillomania and other BFRBs are brutal to live with. It can be exhausting carrying around all those thoughts and feelings by yourself. There are people who love you that want to help lift some of that burden! Reach out to them!
It could be as simple as a text message saying, "I'm having a hard time right now. Can we chat?"
There are also people in the community who dedicate their life to helping others with BFRBs whether that is through free support groups, therapy sessions, coaching, or online courses. Reach out to them! (I'm one of them!)
Have a Hair Care Routine
Through trial and error I have been able to find hair care routines that work for me that keep my hands out of my hair: straight, heatless curls, slick back, braids. The key is wearing hairstyles that I don't want to touch for fear of messing them up.
When my hair is wet I apply Ouai's leave-in conditioner before brushing. Depending on the day I will either use my Revlon blow dryer brush for a straight style, or let it air dry until I'm able to put my hair in heatless curls. Letting my hair air dry all day and then wearing it like that is triggering for me. My regrowth is much curlier than my other hair and so I find myself running my fingers through my hair over and over again.
Heatless curls are wonderful because it gives you a long time without having to touch your hair. Your hair is literally wrapped up! There isn't really a way to touch it without undoing the whole thing. I use the headband method. Once I take the headband out I have clean, bouncy curls that I won't want to touch.
Sometimes I will braid my hair while it is wet and wear it like that for the remainder of the day. I typically do this when I want to do a more complicated style like Dutch milkmaid braids. Braids are a great deterrent. I just took the time to braid my hair perfectly and the slightest touch might mess it up.
I love wearing my hair in a slick back ponytail or bun as a day 2 or 3 style. I wouldn't wear it when my hair is fresh but I would before the next wash day. I use mousse to keep my hair nice and slick and I find that I won't touch it at all.
The Keen2 from HabitAware
Having a tool made for your BFRB is life changing. I purchased my Keen2 in 2021 and have used it since. I have made a ton of videos detailing why I love it but the main reason is the in the moment awareness. Our hands have a mind of their own. I know that when I'm wearing my Keen2 that it will vibrate when I'm doing the scanning behavior. It's now my job to listen to those vibrations and choose a different behavior.
Baseball Caps
Everyone wears a baseball cap. This physical barrier is perfect because you're able to manage your trichotillomania without alerting everyone around you that you're managing your trichotillomania. It covers the scalp. It's lightweight. It's easy to wear with almost any outfit. It's a win-win all around.
Daily Exercise
Any form of exercise is going to positively impact your mental health which will positively impact your trichotillomania. I have an adorable puppy who I get to walk multiple times a day. I also live in beautiful, sunny Florida so being outside is pretty much always wonderful. I can't tell you how much my mood improves just by doing that every single day!
Bandaids/Tape/Liquid Bandaids on my Fingertips
Physical barriers on our fingertips can be super helpful because so much of the trichotillomania experience comes from feeling. It's often the feeling of the hair itself that triggers us to pull it out. Crinkly. Wiry. Coarse. However you describe it, I know the one you're talking about!
Oftentimes people think that you have to wear this type of physical barrier all day long and because of that they won't even try them. My best advice: wear them during a time where you're most likely to pull like when you're working on a computer and/or driving.
Journal
Journaling has incredible benefits for your mental health. Why not journal about your trichotillomania or other BFRB? I created a guided journal, My Trichster Diaries, that takes you through your trichotillomania journey and onto self-love. I also have a course, Sharing Our Stories, that takes you through the journal with me! But if you aren't into journals with prompts here are some times you can journal:
After a big pulling session
When you're thinking about pulling
A moment where you wanted to pull
Have a Bedtime Routine
Staying up late is a huge trigger for many people with trichotillomania and/or other BFRBs. Try your best to go to bed on time and do things that promote a restful sleep. I try not to stay up past midnight! On special and certain occasions I will but typically I'm winding down so that I am asleep before then!
Learn Triggering Locations
Learning my triggering locations allowed me to gain more knowledge of my trichotillomania. It also lets me know when I need to be prepared and how to properly prepare. Again, this is trial and error. I've had trichotillomania for 23 years now so I've tried a lot of different things!
My triggering locations are:
Working on my computer
In the car
Sitting on the couch
I prepare for them by:
wearing physical barriers
taking frequent breaks
wearing my Keen2
setting boundaries (if my Keen2 vibrates more than 3 times while I'm doing something I know to get up and move around)
Frequent Breaks
I grew up in a time where it was commonplace to push through and finish all of your work no matter what. The idea of taking breaks while studying was viewed as slacking off. Instead, I'd work work work and as a result: pull pull pull.
I know now that taking breaks is vital to lessening my pulling and so I do it frequently. Whatever work that I am doing will get completed whether or not I am taking breaks. The only difference is that I am keeping my hair in my scalp and my eyelashes on my eyelids. That's a big enough reason for me!
Crafting
Finding crafts that you enjoy and will keep your hands busy is HUGE!
Busy hands + Nothing to do = Pulling
Try new things. Maybe there is a craft you've always thought you'd enjoy but never had the drive to try it. Try it! I love beading, crocheting, hand stamping, dyeing clothing and using pastels. Whenever I feel like my hands want something to do I grab a craft.
Mirror Work
People with trichotillomania or other BFRBs can have an extremely toxic relationship with the mirror. I know I did! I ONLY used the mirror to scan, pull/pick, and beat myself up. I never once said a kind thing to myself while looking in the mirror. Instead, I called myself names and ranted on and on about how I couldn't stop pulling. Like having a chronic disorder was somehow in my control. Sound familiar?
When I started building a positive relationship with the mirror I started seeing positive changes within me and my trichotillomania. I started to look at myself differently. Instead of scanning my face to see what I could pull/pick, I began complimenting what I saw. I smiled more.
Start by looking at yourself in the mirror for one minute uninterrupted. What thoughts are running around your head? Slowly start implementing compliments. Start saying them aloud. See what magic happens.
To be continued...
Above are some management tools that have worked for me but this isn't the end! I'm sure there will be more! When I find new ones I'll add them here.
Here's to trying new things!
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