Thank you for reading my article. It is thought that hair pulling, like many conditions, is a manifestation of an underlying neuro-structural or biochemical issue. While we don’t yet understand these mechanisms at the cellular or molecular level, we do have observational knowledge about the effects environmental interventions can have on altering a person’s experience with this condition. Medications, such as N-Acetyl Cysteine, are one such environmental intervention that may somehow alter the mechanism through which hair pulling emanates. Psychotherapy, such as CBT, is another such environmental intervention that may somehow alter these pathways. Experience and studies in the field have shown that CBT can achieve changes in brain function and resulting behaviors.

A good analogy to consider would be a medical condition people are more familiar with. Take diabetes, which results from a biochemical imbalance of either the production of or appropriate use of a molecule, insulin. There are a variety of environmental interventions used to treat diabetes. Medications, exercise, and diet are all important therapeutic components. They each act on the mechanism of diabetes in different ways and are complementary in achieving management of the condition.

I’ve worked with clients that have stopped hair pulling by using only psychotherapy interventions and I’ve also worked with clients that experienced significant benefits from using N-Acetyl Cysteine. It is possible that as we learn more about the structural and molecular levels of this condition, we will find that a variety of mechanistic pathways exist such that some people may benefit more or less from certain interventions than others or a variety of combinations thereof. We are at the tip of the iceberg in terms of our neurological understanding of the condition, but in the meantime, its important to try to achieve improvements with interventions we have seen to be of value for many people.