Trichotillomania and ADHD: Is There a Link?

Trichotillomania (trich), or hair-pulling disorder, and ADHD turn up together more often than you’d expect. If you pull your hair and also have ADHD, or you’re the parent of a child with both, you may have wondered whether the two are connected.

This guide covers what the studies show, why the overlap might happen, what’s known about ADHD medicine and pulling, and what helps with both. The research is still small and sometimes mixed, so we’ll say where the answers are clear and where they aren’t.

Is trichotillomania more common in people with ADHD?

Yes. The two conditions appear together far more often than chance would suggest, though exact figures vary between studies.

• A 2022 study of 308 adults with trich in the US found that about 15% met the threshold for ADHD on a screening questionnaire. The researchers compared this with about 2.5% of adults in general.
• A 2020 US survey of more than 10,000 adults found 175 people with current trich. Of those, 29% said they also had ADHD. More than half of the people with both said their hair pulling bothered them more than their ADHD did.

Neither study used a full ADHD assessment for everyone, and most people in the first study were women. So the true figure is uncertain, but every study we found points the same way.

There’s much less research in children, and we don’t yet know how many people with ADHD pull their hair, because most studies start from people with trich.

Why might trichotillomania and ADHD overlap?

Nobody knows for sure. These studies look at people at one moment in time, so they can’t show which condition comes first or whether one leads to the other. But researchers have found some shared threads:

• Acting on impulse. In the 2022 study, people with both conditions scored higher than people with trich alone on every measure of impulsivity: acting without planning, restless movement, and attention that jumps around.
• Pulling on autopilot. A 2021 study sorted adults with trich into three pulling patterns. The most common group pulled mostly without noticing, with fairly weak urges, and had more ADHD symptoms and impulsivity than people without a BFRB.
• Boredom and stimulation. A 2026 study asked 61 adults with trich to log their feelings several times a day. Boredom predicted pulling better than stress or sadness did, and the researchers suggested pulling may partly be a way to add stimulation. The NHS lists fidgeting and restlessness when you’re meant to sit still among the signs of ADHD, and quiet, sit-still moments are also when automatic pulling tends to happen.

Skin picking seems to follow a similar pattern. Our guide to body-focused repetitive behaviours explains the whole group.

Is hair pulling just ADHD fidgeting?

No. Fidgeting is a common sign of ADHD, but trichotillomania is a recognised condition of its own. It means pulling out your hair again and again, causing hair loss, trying to stop and not managing to, and feeling distressed or held back by it. You can have both.

For some people, restless hands drift towards their hair and fidgeting slowly turns into pulling. If pulling leaves thin patches or gaps and you can’t stop, it’s worth treating as trich in its own right.

Does ADHD medication affect hair pulling?

The best evidence so far suggests stimulant ADHD medicine doesn’t make pulling better or worse for most people. But the research is small, so it’s worth watching for changes.

• The worry comes from a handful of case reports, mostly in children, where pulling started or got worse after someone began a stimulant medicine.
• In the 2022 study, 16 adults with both conditions were taking a stimulant. Their pulling was no more or less severe than in people with ADHD who weren’t taking one, and they didn’t report their pulling getting worse after starting.
• An earlier small study of nine children and teenagers with both conditions, described by the same researchers, found methylphenidate (a common stimulant) helped ADHD symptoms without a significant rise in pulling.

That same 2022 study also found that people on stimulants didn’t pull less. So ADHD medicine on its own is unlikely to solve pulling.

What helps with both?

Get support for each condition, and choose trich strategies that don’t rely on remembering or willpower.

• Therapy for the pulling. Therapy based on Habit Reversal Training (HRT) has the most research behind it for trich. It teaches you to notice when you’re about to pull and to do something else with your hands instead. The 2021 researchers suggested that people who pull mostly on autopilot may do best with this kind of noticing training, or with devices that alert you when your hand moves.
• Barriers that do the noticing for you. Plasters on your pulling fingertips, a soft hat or thin gloves during homework, work or TV make pulling harder without needing you to catch it in time.
• Fidgets where you pull. Choose ones that give a similar feeling to pulling, such as texture or a small tug, and keep them at your desk, in bed and in the car.
• Short bursts with breaks. Long, still stretches invite boredom and automatic pulling. The NHS suggests breaking tasks into slots of 15 to 20 minutes for children with ADHD, and many adults find the same helps.
• Support for the ADHD too. ADHD support can include medicine, talking therapies such as CBT (cognitive behavioural therapy), and changes at school or work. Tell each professional about both conditions, because pulling is easy to miss in an ADHD appointment.

You can read how habit reversal works in our guide to Habit Reversal Training. Our guide to fidget toys and tools goes through the options for busy hands.

Be kind to yourself when you slip. Shame tends to feed more pulling, and an ADHD brain already hears plenty of “try harder”. Our guide on how to stop pulling your hair has a step-by-step plan for urges.

What if my child has ADHD and pulls their hair?

Stay calm and treat the pulling as something to understand, not something to punish. Pointing it out or telling them off usually adds shame and makes pulling worse.

• Tell their ADHD team or doctor, and mention whether the pulling began or changed around a change in medicine.
• Set up homework time with a fidget within reach and short breaks built in.
• Work on strategies together, letting your child choose which barriers and fidgets they want to try.

If you’d like a fuller plan, start with The Parent’s Guide to Trichotillomania: understanding what your child is going through.

When should I get help?

Get support if pulling is leaving thin patches, taking up your time, causing you distress, or affecting your work, school or relationships, or if it changed after an ADHD medicine was started or adjusted. You don’t need to wait until it feels “bad enough”.

Many doctors and therapists know about ADHD but have never worked with someone who pulls. Look for someone who understands hair pulling, and ask whether they also work with people who have ADHD. Everyone in our directory has told us they understand trichotillomania and already help people who pull, in person or online. You can search the directory. For the bigger picture of the conditions that often come alongside trich, see our complete guide to trichotillomania.

If you’re feeling very low or hopeless, please talk to someone today.

In an emergency, call 000 or go to your nearest emergency department.

• Lifeline — 13 11 14 (www.lifeline.org.au)

Questions people ask

Sources

1. Chesivoir, E.K., Valle, S. & Grant, J.E. (2022). Comorbid trichotillomania and attention-deficit hyperactivity disorder in adults. Comprehensive Psychiatry, 116, 152317.
2. Grant, J.E., Dougherty, D.D. & Chamberlain, S.R. (2020). Prevalence, gender correlates, and co-morbidity of trichotillomania. Psychiatry Research, 288, 112948.
3. Grant, J.E., Peris, T.S., Ricketts, E.J., Lochner, C., Stein, D.J., Stochl, J., Chamberlain, S.R., Scharf, J.M., Dougherty, D.D., Woods, D.W., Piacentini, J. & Keuthen, N.J. (2021). Identifying subtypes of trichotillomania (hair pulling disorder) and excoriation (skin picking) disorder using mixture modeling in a multicenter sample. Journal of Psychiatric Research, 137, 603–612.
4. Gallinat, C., Wilhelm, M., Moessner, M. & Bauer, S. (2026). Trichotillomania: The interplay between emotional states, urges and hair pulling episodes. Comprehensive Psychiatry, 149, 152727.
5. American University (2024). Examining age of onset, symptom severity, and neuropsychological performance in comorbid trichotillomania and ADHD. Doctoral dissertation, American University College of Arts and Sciences.
6. NHS. ADHD in children and young people.