Maybe it happens while you read, scroll your phone or sit in traffic. Your fingers find a hair that feels different, and before you know it you have pulled it out. Maybe you've tried to stop many times and feel frustrated or embarrassed that you can't. If you've ever wondered why do people pull their hair out, the short answer is that hair pulling is often tied to urges, tension and a brief sense of relief, and it is not a simple bad habit. This post explains hair pulling in adults, how it relates to OCD, why the urge keeps coming back and what can help.
This post is general information, not a diagnosis or medical advice.
Why do people pull their hair out?
People pull their hair for different reasons, and many describe more than one. Some notice a build-up of tension or an itch-like urge that eases once a hair comes out. Others pull without noticing, during quiet or absorbing tasks, and only realize afterwards. Some people describe a mix of both.
MedlinePlus, a service of the US National Library of Medicine, describes common signs such as an increasing sense of tension before pulling and a sense of relief or gratification afterwards. That cycle of tension and relief helps explain why the behaviour can feel so hard to stop, even when you really want to.
What is hair pulling disorder?
Hair pulling disorder, also called trichotillomania, involves repeated urges to pull or twist hair. MedlinePlus describes it as a type of obsessive-compulsive and related disorder, and notes that its causes are not clearly understood. People may pull from the scalp, eyebrows, eyelashes or other areas.
Hair pulling disorder symptoms can include:
Repeated pulling, tugging or twisting of hair
Rising tension before pulling, and relief or satisfaction after
Noticeable thinning or patches, which some people work hard to hide
Trying to cut back or stop, without lasting success
Feeling sad, anxious or self-conscious about the pulling
Only a qualified professional can make a diagnosis. You don't need one to talk about what you're experiencing. Many adults come to a first session simply wanting to understand the pattern better, and that is a perfectly good place to start.
Trichotillomania in adults
Although hair pulling often begins earlier in life, trichotillomania in adults is common, and many people carry it quietly for years. Adults often describe shame, a sense that they "should" be able to stop and a lot of energy spent covering it up with hairstyles, hats or makeup.
That secrecy can be exhausting. It can also keep people from reaching out, because they worry they'll be judged. In counselling, hair pulling is treated as a real concern that deserves care and understanding, not as a character flaw.
Hair pulling and OCD, what is the difference
People often link hair pulling and OCD, and there is a connection. The National Institute of Mental Health describes OCD as a disorder marked by uncontrollable, recurring thoughts (obsessions), repetitive and excessive behaviours (compulsions), or both.
Hair pulling sits in the same broad family of obsessive-compulsive and related conditions, but it tends to work differently. Researchers often group it with body-focused repetitive behaviours, a set of repeated behaviours directed at the body that also includes skin picking and nail biting. In OCD, a compulsion usually aims to neutralize a feared thought. Hair pulling is more often about soothing tension, boredom or a physical sensation.
Some people have both. A therapist can help you understand what drives your pulling, which matters for choosing the right approach.
Why do people pull their hair out when stressed?
Many people notice they pull more when stressed, anxious, bored or tired. Researchers have studied an emotion regulation model, which suggests that body-focused repetitive behaviours like hair pulling can work as a way to manage uncomfortable feelings, even though they cause problems of their own.
Interestingly, a large meta-analysis found that hair pulling and skin picking were less strongly linked with negative emotions, such as stress, anxiety and low mood, than OCD was. In other words, "why do people pull their hair out when stressed?" answers only part of the question. Pulling can also show up in calm, quiet moments, such as reading, studying or watching TV.
This is why "just stop" so rarely works. The behaviour is often doing a job for you, whether that's easing tension, filling a quiet moment or settling a sensation, and it can happen outside your awareness.
What helps people pull less
The best-studied approach for hair pulling is behavioural therapy that includes habit reversal training. In an updated meta-analysis of randomized trials, behavioural therapy with habit reversal components showed a large benefit for reducing symptoms and had the strongest evidence base of the approaches studied.
Habit reversal, in general terms, involves:
Awareness training: learning when, where and how pulling tends to happen
Competing responses: practising something your hands can do instead when the urge shows up
Support and review: tracking progress and adjusting what isn't working
Your therapist may also draw on cognitive behavioural therapy (CBT) to work with the thoughts and feelings around pulling, and on acceptance-based skills to sit with urges without acting on them. Many people also work on shame, because feeling less ashamed often makes the urges easier to handle.
Progress usually isn't a straight line. Slips are part of learning, not proof that it isn't working. A hard week often tells you something useful about your triggers, which you and your therapist can use to adjust the plan.
How counselling can help
Counselling gives you a private, judgment-free space to talk about hair pulling, often for the first time. Together, you and your therapist can map your patterns, practise new responses and work on the stress, anxiety or self-criticism that often comes with them.
We work with adults on hair pulling and related concerns. If OCD is also part of your picture, our OCD counselling page explains how we help with that. You may also find our post on why people with OCD count useful for understanding how compulsions work.
Getting started
We offer counselling for adults at our Kitchener-Waterloo, Cambridge and Ottawa offices, and every service is offered at every location. If you would like to know whether sessions for hair pulling can be in person or online, ask in your free consultation.
Insurance may cover some or all of your sessions, depending on your plan, so check your plan.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers, including for sessions with an RP (Qualifying). Desjardins is the exception: through TELUS eClaims, we can direct bill Desjardins for sessions with an RSW, RP or psychologist, but not for an RP (Qualifying).
Book a free 15-minute consultation with our admin team to talk about hair pulling and which therapist might be a good fit.
If you're in crisis: if you or anyone else is in immediate danger, call 911. If you're having thoughts of suicide, call or text 9-8-8 any time.
Hair pulling is not a failure of willpower. With the right support, change is possible.
Last reviewed: October 2026
Sources
MedlinePlus, US National Library of Medicine, Trichotillomania
National Institute of Mental Health, Obsessive-Compulsive Disorder (OCD)
Farhat LC, Olfson E, Nasir M, et al. Pharmacological and behavioral treatment for trichotillomania: An updated systematic review with meta-analysis. Depression and Anxiety, 2020 (PubMed ID 32390221; cited for the behavioural therapy finding only)
Roberts S, O'Connor K, Bélanger C. Emotion regulation and other psychological models for body-focused repetitive behaviors. Clinical Psychology Review, 2013 (PubMed ID 23792470)
Snorrason I, Kuckertz JM, Swisher VS, et al. Hair pulling disorder and skin picking disorder have relatively limited associations with negative emotionality: A meta-analytic comparison across obsessive-compulsive and related disorders. Journal of Anxiety Disorders, 2023 (PubMed ID 37499420)