Alopecia isn’t a subject that’s discussed very openly in society and a lot of people still don’t know what it is.
Perhaps even less known, and certainly less understood, is Trichotillomania (TTM, or ‘tric’ for short).
Just like other forms of alopecia, the results are the same – patchy or even total baldness. But with TTM, the sufferer has pulled the hair out themselves, which can be particularly distressing.
Sam Faiers, from The Only Way Is Essex, recently revealed that she lost her eyelashes due to TTM, and it’s thought that around 4 per cent of the population will experience compulsive hair pulling at some point in their lives.
Women seem more prone than males, with pulling usually starting around age 12, but it can start later in life too.
Despite being self-inflicted, the hair loss is no less difficult to live with, as Lucinda Ellery sees almost every day.
‘There’s a massive lack of awareness, and girls with TTM are very isolated,’ says Lucinda, who runs a specialist hair-loss consultancy.
Often the TTM seems to have been triggered by high stress or anxiety, such as a relationship breakdown, divorce, or even pressures at school or work.
These are patterns often seen with eating disorders, and other forms of self-harm, also rooted in psychological factors and very difficult to curb.
Hair pulling becomes a compulsive response, with many saying they’re barely even aware that they’re doing it at first.
But eventually they’ll realise they’ve caused a bald patch, and by this point the habit can be deeply ingrained.
As well as living with the hair loss, sufferers have to cope with shame and embarrassment.
‘The condition needs a lot of understanding,’ adds Lucinda.