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Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. [2] [4] A brief positive feeling may occur as hair is removed. [5] Efforts to stop pulling hair typically fail.
Trichilemmal cysts are derived from the outer root sheath of the hair follicle. Their origin is currently unknown, but they may be produced by budding from the external root sheath as a genetically determined structural aberration. They arise preferentially in areas of high hair follicle concentrations, so 90% of cases occur on the scalp.
"During this phase, hair growth stops, and the outer root sheath shrinks and attaches to the root of the hair," says Dr. Kinler. "This detachment is a natural process as the hair prepares to enter ...
The inner root sheath (IRS) consists of: a delicate cuticle next the hair, composed of a single layer of imbricated scales with atrophied nuclei; Huxley's layer; Henle's layer; The term "trichilemmal" refers to the outer root sheath. [2] The IRS functions to mould, adhere, as well as participate in the keratinization of growing hair. [3]
Once the hair has been pulled out, persons with trichophagia might rub the hair against their lips, roll the hairs around and inspect them, bite off and swallow the bulb of the hair, or ingest the entire hair shaft as well. [9] Typically, ingested hair remains asymptomatic and is not harmful.
The abnormalities caused by the inner root sheath creates disruption in the support and anchoring of the anagen hairs. [9] Patients with loose anagen hair syndrome have mutations in the protein keratin K6HF, which is located in the middle of the hair shaft and inner root sheath, the companion layer. [11]
During this phase the hair grows about 1 cm every 28 days. A hair pulled out in this phase will typically have the root sheath attached to it which appears as a clear gel coating the first few mm of the hair from its base; this may be misidentified as the follicle, the root or the sebaceous gland by non-health care professionals. Scalp hair ...
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