Dr. John Frank Talks To ABC News about Trichotillomania
By Dr. John Frank, M.D. – IAHRS, ABHRS,ISHRS, AHLA, XM Radio: ‘The Bald Truth’, NYC, March 5, 2011
Host: Joining us right now to give us more insight is Dr. John Frank, Board Certified Head and Neck Surgeon and Hair Loss Specialist. Doctor, thanks so much for joining us today.
Dr. John Frank: You’re welcome.
Host: So it’s called trichotillomania or trich for short. And the latest evidence shows that it’s not just a bad habit like biting your nails. It’s something more serious.
Dr. John Frank: Well, obviously, from what we just saw, it can really affect somebody severely. It can be really a problem, very, very devastating.
Host: When does this start in a person’s life? Does it start early in their life? Can it start at any time and what triggers it?
Dr. John Frank: You may see some children with it and that’s not really a serious version of it. But then, as you go through adulthood, it can occur at any age to adults, men more than women, and it’s a long spectrum of the obsessive compulsive disorders and we think that there are some biological components to it.
Host: Right. How often do you see this condition in your office?
Dr. John Frank: I mean I’m a hair loss specialist and hair loss surgeon and I treat all different types of hair loss. And when we do see somebody with trichotillomania, we treat it but the challenge is to learn who actually has it because it’s either covered up or it’s hidden. And even if somebody is coming to me with the problem, it may take a visit or two before they actually have the courage to say what’s happening.
Host: Right. So this is rare. People don’t really talk about it that often and that’s why not many people know about it, right?
Dr. John Frank: People don’t like to talk about it. They are embarrassed. There is the emotional component of having hair loss, which is embarrassing. And then the other second part of the emotional component is you are doing it to yourself and so it’s something that you’re shy about — you don’t want anybody to know about it.
Host: Right. I’m sure you have to tread very lightly.
Dr. John Frank: I’ve seen people that will come in and I’m the first person that has looked at their scalp in 20 years, I mean, including family members. They are hiding it from everybody. And it takes a special sensitivity, good judgment, a knack for being very sensitive and understanding and — being a good listener.
Host: Right. How do you treat the condition?
Dr. John Frank: There are a number of treatments for it. None of them are very effective. There are medications like some of the obsessive compulsive disorders, the antidepressants and things like that, and some of them can be effective on a short-term basis. People can undergo therapy and there are some behavioral modification treatments, but I’m not that impressed by their results. Of course, some types of therapy more effective than others. And then there are some topical treatments and wigs and even surgery for trichotillomania.
Host: Right. Now, this is obviously a lifelong battle and there are support groups, I understand.
Dr. John Frank: Fortunately, there are. There are places to go. The effectiveness of the support group is going to be dependent upon the individual. Some people are great in support groups. Other people would just as soon not go to a support group. But they are available. They are online and you can go and get help, share with other people. If you can go through it with somebody, it may be helpful.
Host: All right. Hair loss is devastating. So for the people that are pulling their own hair out, can you replace the hair?
Dr. John Frank: It can be replaced. But if it’s replaced and they pull it out again, it’s like pouring water into a bucket with a leak. So the main thing is to stop the cause of the hair loss, and in front of that is to diagnose what’s happening. Some people do it and they don’t even know they are doing it. Maybe they are doing it in their sleep or subconsciously while they are daydreaming, and it doesn’t just occur on the scalp. They can be doing it on their eyelashes and things like that.
Host: Right, right. And you mentioned that there are some topical treatments for this, medications?
Dr. John Frank: Well, there are some cover-ups, some aesthetic things that can be done, and wigs and extensions and things like that or ways to color, even tattoo. But that’s like putting a Band-Aid on an open wound, so you really want to try and uncover the root of the problem.
Host: Right. It’s a very sensitive issue, isn’t it, and devastating at the same time.
Dr. John Frank: It is. On one hand, hair loss for young men, you can joke about it and there are many different monikers that young guys have. But when you really start to understand hair loss, it can be extremely devastating, and that’s part of the problem because not everybody takes it so seriously.
Host: Right. Well, Doctor, thanks so much for shedding more light on this problem.
Dr. John Frank: You’re welcome.
© 2012, John Frank, M.D.
