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Warning-sign checks

Trichotillomania: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Get emergency medical help if hair swallowing is followed by severe or worsening abdominal pain, repeated vomiting, a swollen abdomen, fainting, blood in vomit or stool, or an inability to pass stool or gas.

    These can be signs of a digestive blockage or injury.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Seek prompt medical advice for increasing redness, warmth, swelling, pus, worsening pain, or fever, as these may suggest a skin infection.

    Urgent mental health support is also appropriate if you feel unable to stay safe or are thinking about suicide or serious self-harm.

    Hair pulling itself is usually not intended as self-harm, but severe distress can occur alongside it.

  3. 3

    Does any of this apply?

    Book an appointment

    Arrange a routine appointment if you repeatedly pull your hair, have areas of hair loss, cannot stop despite trying, or feel distressed or limited by the behaviour.

    You can also seek help if you are unsure whether pulling is causing the hair loss.

The article also says

Mention any hair swallowing.

A primary care professional, mental health professional, or dermatologist may be involved depending on your symptoms.

Every sign above is quoted from the sofidex article on Trichotillomania. If you are not sure, err upward — it is always reasonable to be checked.