Successful Long-Term Management of Trichotillomania Using Individualized Homoeopathic Treatment: A 10-Year Follow-up Case Report

Abstract

Background

Trichotillomania (Hair Pulling Disorder) is a chronic psychiatric disorder characterized by recurrent, irresistible urges to pull out one's own hair, leading to noticeable hair loss and significant psychosocial impairment. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), trichotillomania belongs to the spectrum of obsessive-compulsive and related disorders. The condition commonly follows emotional stress, anxiety, grief, or interpersonal conflicts and frequently exhibits a relapsing-remitting course. Conventional treatment mainly consists of cognitive behavioural therapy, habit reversal training, and selective serotonin reuptake inhibitors, although long-term remission remains difficult to achieve.

Homoeopathy individualizes treatment by evaluating the patient's constitutional makeup, emotional conflicts, personality traits, and physical characteristics in addition to the local manifestations. This report describes successful long-term management of chronic trichotillomania with individualized homoeopathic treatment over a ten-year follow-up period.

Case Presentation

A 33-year-old female teacher presented with recurrent episodes of compulsive hair pulling since 2010. Hair pulling was predominantly precipitated by emotional stress, family conflicts, occupational pressure, grief, and psychological frustration. She experienced repeated relapses associated with hyperthyroidism, infertility, miscarriage, pregnancy-related emotional stress, and conflicts within the family. Detailed constitutional assessment revealed a sensitive, emotional, easily weeping woman with suppressed emotions, marked overthinking, tendency to remain alone, and strong desire for appreciation. Individualized homoeopathic treatment consisting of constitutional remedies, including Pulsatilla, later Natrum carbonicum, supported with Kali phosphoricum, resulted in marked reduction in hair-pulling impulses, improved emotional resilience, restoration of confidence, and prolonged periods of remission.

Outcome

The patient demonstrated progressive reduction in compulsive hair-pulling behaviour with complete remission during several follow-up periods. Relapses corresponded closely with identifiable emotional stressors such as infertility, thyroid illness, occupational stress, and bereavement. During the later years of treatment, the patient developed awareness of the behaviour and consciously stopped herself whenever the urge appeared. Overall psychological well-being, confidence, and quality of life improved substantially.

Conclusion

This case demonstrates the potential role of individualized constitutional homoeopathy in the long-term management of chronic trichotillomania and emphasizes the importance of addressing underlying emotional conflicts and constitutional susceptibility.