# Hair Care and Hair‐Focused Repetitive Behaviors: A Descriptive Cross‐Sectional Study

## TL;DR

This study explores how hair care routines interact with hair-pulling behaviors in people with hair-focused repetitive behavior disorders, finding that certain practices can reduce urges.

## Contribution

The study introduces insights into how specific hair care practices may influence hair-pulling behaviors and the potential role of hair professionals in managing these disorders.

## Key findings

- Washing and haircutting were reported to reduce hair-pulling urges in over half of participants.
- Thematic analysis revealed sensory and routine-based factors influencing hair-pulling behaviors.
- A minority found that touch from others reduced their urges, suggesting potential therapeutic approaches.

## Abstract

Hair‐Focused Repetitive Behavior Disorders (HFRBDs), commonly associated with trichotillomania (TTM), including hair pulling, manipulation, or ingestion, can cause significant emotional, physical, and social distress. This study aimed to (1) identify hair care‐related behaviors among individuals with HFRBDs; (2) explore how these practices relate to hair‐pulling behaviors; and (3) examine the potential role of hair professionals in supporting affected individuals.

An online survey was conducted with adult participants (n = 195) who self‐identified as having HFRBDs involving scalp hair. The survey assessed hair‐pulling behavior, personal and professional hair care routines, and perceived effects of these practices. Both quantitative and qualitative data were collected and analyzed.

Findings showed that constructive hair care practices often coexisted with hair‐pulling behaviors. Participants reported that washing (54.1%) and haircutting (34.1%) helped reduce pulling urges, while styling (8.7%) and combing/brushing (15.4%) had minimal effect. Notably, 27.7% stated that their own touch increased urges, while 9.8% found that another person's touch reduced them. Thematic analysis of 501 open responses revealed categories such as pre‐pulling routines, sensory responses to hair texture, and varied experiences with hair salons.

The study highlights the complex relationship between hair care and HFRBDs. Tailored hair care strategies may offer meaningful support for individuals with HFRBDs and could be integrated into guidance provided by clinicians, dermatologists, and hair professionals. Personalized interventions may improve overall management of the condition.