A. Recurrent pulling out of one's hair resulting in noticeable hair loss.
B. An increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior.
C. Pleasure, gratification, or relief when pulling out the hair.
D. The disturbance is not better accounted for by another mental disorder and is not due to a general medical condition (e.g., a dermatological condition).
E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Trichotillomania can be easy to identify if you can see the person has pulled hair out of their head, which is often the case. Patches of hair can be seen as missing, as they usually pull from one section at a time and then move onto a new section in attempt to avoid permanent hair loss.
Having trichotillomania can feel like an urge or stressful experience until the hair is pulled, and then a feeling of relief is experienced. This feeling of relief only encourages more hair to be pulled.