The Sad, Secretive Hair-Pulling Disorder

April 25 -- Stephanie Recob began doing it when she was 11 years old. By 13, she was bald and wearing a wig to hide her painful secret.

"My head is ugly. Think of an 80-year-old man with no hair — that's what I look like," said Recob.

At 19, Recob is smart and athletic, but the college junior just can't stop pulling out her hair. She suffers from trichotillomania, "trich" for short.

Recob has never shown her head to anyone outside her family and says she never will. As odd as Recob's case may sound, it is not rare. An estimated 4 million women and 2 million men across the country are doing this to themselves.

Recob says she can go only two or three days without pulling her hair. "I don't understand it. I don't understand why I pull my hair out. It's not my fault. I don't do it on purpose. If I could stop I would," she said.

A ‘Body Focus Disorder’

Doctors aren't sure what causes trichotillomania. It usually starts in early adolescence. Researchers speculate that it's caused by a grooming gene gone berserk.

Despite what it looks like, it's not self-mutilation, it's not triggered by trauma, and because there are no obsessive thought patterns involved, it is not considered an obsessive-compulsive disorder. Instead, trich is a "body focus disorder," similar to severe nail biting or extreme skin picking. The condition is chronic and there is no cure.

Recob has tried everything she can think of to quit — from wearing stocking caps to bed at night or mittens on her hands to drug therapy. "I was on Anafranil, BuSpar, Luvox, Neurontin, Ambien, Zoloft, Prozac," she said. Sadly, none of it worked.

Doctors believe, for some people, a combination of antidepressants and behavior modification can help. But for some patients, like Recob, these therapies simply do not work.

Pleasure, Pain and Shame

The relentless, uncontrollable urge to pull has a profound effect on people's lives.

"The emotional impact is very deep. People feel very ashamed of their pulling," says Jennifer Raikes, who suffers from a relatively mild form of trich and has made a documentary film, Bad Hair Life, about the disorder.