Abstract Trichotillomania is an impulse control hair-pulling disorder resulting in hair loss. Trichotillomania is often disabling, leading to significant distress, impaired functioning and significantly low quality of life. It is associated with a high degree of comorbidity, particularly psychiatric conditions such as anxiety disorders, depression and attention deficit/hyperactivity disorder. The objective of this systematic review is to critically review all currently available data to understand the psychosocial burden in patients with trichotillomania. Furthermore, this study will provide sufficient information to dermatologists and physicians to recognize and raise awareness on the psychosocial impact of trichotillomania. A comprehensive literature search was conducted using PubMed, employing the search terms ‘trichotillomania’ AND ‘hair pulling disorder’ AND ‘depression’ OR ‘psychological’ OR ‘psychosocial’ OR ‘self-esteem’. Studies published from January 2014 to June 2024, in English, over the last 10 years were included based on predefined inclusion and exclusion criteria. In total 23 studies were included in the final analysis after the initial process. Research indicates that individuals with trichotillomania frequently experience functional impairments across various domains, including social interactions, academic performance and overall quality of life. The presence of comorbid conditions exacerbates the severity of trichotillomania symptoms, creating a complex interplay that complicates treatment. Trichotillomania is a multifaceted disorder requiring holistic management strategies, addressing both the psychological and physical aspects of the disorder. Given the high levels of comorbidity and the significant impact on quality of life, there is a critical need for increased awareness, early intervention and tailored treatment plans that incorporate both therapeutic and supportive measures.
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