What Trichotillomania Really Looks Like, As Told Through Photos

Happiness doesn't come from a full head of hair or having eyebrows.

October 1-7 is BFRB Awareness Week. BFRBs, or Body-Focused Repetitive Behaviors, include trichotillomania (hair pulling), dermatillomania (skin picking), nail biting, skin/cheek biting, and many other compulsive behaviors involving the body. To learn more, visit: bfrb.org.

I have had trichotillomania since I was 11 years old. I’ve already documented my story of what it’s like to live with trich as a teenage girl in the article titled, “I’m a Teenage Bald Girl.” But in the spirit of BFRB Week, I wanted to literally show visually what it’s like to have trichotillomania, and how drastically it can alter your appearance. At the same time, though, and perhaps more importantly, I want to spread the message that we are worth so much more than our appearance. For so long, my appearance dominated my life and determined how happy I was. Over time, I’ve realized that happiness doesn’t come from a full head of hair or having eyebrows… it comes from loving myself just as I am. 

(From left to right)

#1 March 2013: I was 14 and halfway through my freshman year of high school, when after about a two year period of a relatively low amount of pulling, I started severely pulling again. This picture was taken on Easter, just two weeks after my pulling flared up. I quickly became very withdrawn, depressed and distant from others. I felt ugly and damaged, and thought that everyone else viewed me that way too. Although I may be smiling on the outside, on the inside I was the farthest thing from happy.

#2 April 2013: In a matter of only weeks, I had a large bald spot that was only growing bigger. My naturally thick curly hair rapidly lost density. I spent many nights crying after a pulling spree, and this was one of those nights. I resorted to ponytails and barrettes to hide the damage.

#3 September 2013: First day of school, 10th grade. My bald spot had slowly started growing back, but as you can clearly see, my hair was significantly thinner.

#4 February 2014: This was taken the day I started pulling out my eyebrows. I had created a tiny gap in one of them and filled it in with an eyeliner pencil.

#5 April 2014: My first haircut in almost four years (at the time). I had avoided going to the hairdresser for years, but my mom and I found one who specializes in hair loss, and has worked with trichotillomania clients. My hairdresser, Bianca, was incredibly compassionate and empathetic, and definitely knowledgeable in the subject. It was the first time I really felt validated about my trich, because she didn’t talk to me about it as if it was my fault. She made sure the whole time that I was comfortable. She not only styled my hair in a way that concealed the sparse areas, but she also made my hair look thicker overall. That haircut was the first time in a very long time that I had actually felt good about the way I looked.

#6 July 2014: While my new haircut significantly decreased my pulling, it only took a couple months for it to get bad again. Soon, I developed yet another bald spot. I had an upcoming family function, and was more than a little scared about how I was going to hide it. I spent the weeks leading up to the event practicing various hairstyles, in an effort to find something that worked.

#7 November 2014, Thanksgiving: My hair was getting increasingly thin again and my bald spot grew, but by this point I had discovered Toppik, a shake on powder to camouflage bald spots. Of course on Thanksgiving of all days, when I would be seeing my family, I went to shake it on, only to find that there was absolutely none left. I went into panic mode, scrambling to find an alternative, and finally settled on a bun. I was very upset, however, that I was unable to wear my hair down like I had planned.

#8 April 2015: My hair was still getting thinner. But after attending my first TLC Foundation for BFRBs conference, something within me had changed. I no longer wanted to keep this a “big secret.” And I realized that I am not in fact “damaged.” At the conference I felt comfortable enough to skip using Toppik. This picture was taken the day after the weekend long conference, when I felt brave enough to walk around Washington, DC sightseeing all day, with my bald spots completely exposed. I felt the wind in my hair, and for the first time I didn’t feel a sense of panic... I felt free. Of course, when I returned to school, I resumed using Toppik, but it was still huge for me to go out in public for the first time au naturel, just as I am.

#9 May 2015: Just one of the many areas of sparseness on my head. I could no longer adequately cover up my hair loss with Toppik, ponytails or headbands.

#10 May 2015: At the TLC conference, I had learned about this amazing charity called Hair Club for Kids, which provides custom made hairpieces, free of charge, to children under age 18. This picture is after I got my first hairpiece glued on. My mom and I both cried when I got it put on; I looked like my “old” self again with beautiful curly hair. For the first time in years, I was able to wake up in the morning and head out the door just like that, without having to worry about hiding the “damage” I’ve done to myself.

#11 January 2016: My eyebrows were getting quite bad again.

#12 April 2016: After attending my second TLC conference, I had gained a renewed sense of confidence. This picture was taken the day I went out in public for the first time without drawing on the tail end of my eyebrows. My smile here is genuine.

#13 May 2016: My hairpiece came off, and although it was very short, the hair on top of my head had grown a lot. I only had a thin layer of long hair left in the back that was undamaged, and basically had a mullet.

#14 May 2016: I cut the remaining long hair to the same length as my regrowth, resulting in a fabulous pixie cut. I finally felt comfortable with not hiding myself.

#15 June 2016: I shaved my head the day before the last day of school, and I graduated high school with a buzzcut!

#16 September 2016: I’m almost 18, bald and eyebrow-less, and yet I’ve never been happier! I’ve come a long way from when I was 14. I’ve gained a lot of confidence and no longer define myself by my hair (or lack thereof).

You never know what someone might be going through. Someone may look fine and as if they have it all together on the outside, but in reality may be suffering in silence and internally fighting a battle with themselves. I know I definitely felt that way in the beginning. I wanted nothing more than to appear “normal.”

Looking back on my journey through the years was difficult. I feel a sense of mourning for everything I missed out on in my early teenage years, because I was so worried about my “secret” being revealed. I look at the first picture compared to the last one, and I honestly can’t believe that that’s the same person. I look at these photos and see a girl who looks drastically different. But if you dig a little deeper, you’ll see that she’s changed on the inside, too, for the better.

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