Trichotillomania: ophthalmic presentation

Purpose:A case of trichotillomania, or compulsive hair‐pulling, involving the eyelids is presented to alert ophthalmologists to this common, but frequently overlooked cause of eyelash and eyebrow alopecia.Methods and results:Clinical records of a 33‐year‐old woman suffering from trichotillomania were reviewed. Compulsive hair‐pulling began in childhood and had become chronic. Psychiatric intervention was unsuccessful.Conclusions:The diagnosis of trichotillomania is made on history and slit‐lamp examination findings. A skin biopsy may be necessary to exclude alopecia areata. Adults should be referred to a psychiatrist. Although childhood disease is usually benign, often reflecting a disturbed parent‐child relationship, in adults hair‐pulling is generally chronic and associated with psychiatric illness.