Does Trichotillomania Go Away? The Long-Term Outlook

If you’ve pulled your hair for years, you’ve probably wondered whether it will ever stop. Or you may be a parent asking whether your child will grow out of it. This guide sets out what the research says about the long-term outlook for trichotillomania (trich).

The short version: trich rarely disappears overnight, but many people pull far less over time, and some stop altogether.

Is there a cure for trichotillomania?

No. There’s no cure, in the sense of a pill or single treatment that switches trich off for good. But trich can be managed well, and for some people it fades almost completely.

Researchers talk about remission instead. Remission means you no longer meet the full diagnosis, even if you still pull now and then. Recovery usually means staying in remission for a long time, often a year or more.

Trich is a body-focused repetitive behaviour (BFRB), one of a group of conditions where people repeatedly pull, pick or bite at their hair, skin or nails. It isn’t a bad habit, attention-seeking, self-harm or a lack of willpower, and it responds to the right kind of help. Our complete guide to trichotillomania covers the basics.

Does trichotillomania go away on its own?

Sometimes. Left untreated, trich often lasts for years, rising and falling in waves. But in a large US study, about 1 in 4 adults who’d had trich no longer had symptoms and had never had therapy or medication for it. Researchers call this natural recovery.

A smaller follow-up of 21 adults who recovered this way adds detail:

• It can take years. They had met the diagnosis for about 13 years on average, and stopped in their mid-to-late twenties.
• It isn’t only mild cases. At their worst, they had pulled just as often as people who still had trich.
• It’s often not all-or-nothing. Nearly 8 in 10 still pulled occasionally or had swapped pulling for another habit, such as nail biting.
• Other conditions matter. People who recovered on their own were less likely to have conditions such as ADHD (attention deficit hyperactivity disorder), OCD (obsessive-compulsive disorder) or depression.

So waiting it out can work, but it’s a gamble. The researchers suggested that recovery through treatment may be more complete.

Do children grow out of trichotillomania?

It depends on their age. Hair pulling in babies and toddlers is common and usually isn’t trichotillomania. It’s often a way of self-soothing, alongside thumb sucking or while falling asleep, and it often stops on its own.

Our guide to toddler hair pulling explains what to do in the meantime.

Pulling that starts around ages 10 to 13 is more likely to stay without help, but children and teens respond well to behaviour therapy. In the first randomised trial for young people aged 7 to 17 (a study where people are placed in groups by chance), eight weekly sessions reduced pulling clearly more than the comparison group’s care, and the gains held through two further months of lighter sessions. It was small, with 24 young people, so it’s a promising start rather than the final word.

How parents respond matters too. Scolding, watching or punishing pulling adds shame, and shame tends to feed pulling. Children’s hospital guidance notes that early treatment can be effective.

Does treatment help in the long run?

Yes, for many people, though keeping the gains takes ongoing effort. Therapy based on HRT has the most research behind it. It teaches you to notice when you pull, to use a competing response (something you do with your hands that makes pulling impossible, such as clenching your fists for a minute), and to change the places where pulling happens.

In trials of one-to-one HRT, most people improved by the end of treatment, though fewer stopped completely. The longer view is more mixed. In a Dutch study of 28 people who had six sessions, much of the improvement had worn off two years later, but on average people were still better off than before. Across several trials, between half and two-thirds of people who improved had slipped back by the last check-in.

Trich is best treated as something you manage over time. One small trial of a longer programme that added skills for handling emotions found that none of the people who improved slipped all the way back, although some lost part of their gains.

For an overview of every option and the evidence behind each, see our guide to trichotillomania treatment.

Why does pulling come back after a good spell?

Because trich tends to come in waves. Stress, big changes, boredom, tiredness, low mood or a new pulling spot can bring urges back, sometimes after months or years of calm. A setback is part of the condition, not proof you’ve failed.

Research points to a few things linked to keeping gains:

• Stopping completely, not just cutting down. In two studies, people who had stopped pulling by the end of treatment were much more likely to stay well.
• Lower levels of depression. People with fewer symptoms of depression before treatment did better two years later.
• Urges alone don’t decide it. In one study, still feeling urges after stopping didn’t make people more likely to slip back.

A slip is one pull or one hard evening. A relapse is when pulling settles back to where it was before. Catching a slip early and going back to your tools can stop one turning into the other.

Our guide to handling a relapse walks through what to do next.

What does recovery from trichotillomania look like?

For most people, recovery means pulling much less, much less often, with pulling no longer running their life. It rarely looks like a straight line to zero. Many people who recover still have the odd urge or pull, and some stop completely.

Signs of recovery people often notice:

• More pull-free days, and shorter episodes when they do pull
• Catching the urge, or the hand on its way up, earlier
• Knowing what to do after a slip, instead of spiralling
• Less time spent hiding or covering their hair
• Less shame, and more room for everything else in life

If hair regrowth is on your mind, our guide to whether hair grows back after trichotillomania covers what to expect.

What makes a good long-term outlook more likely?

A few things tip the odds your way. Work with someone who understands hair pulling and works on the pulling itself. Aim to stop completely, then protect it, since that’s one of the clearest signs gains will last. Get help for conditions that often come with trich, such as depression or ADHD, which researchers suggest may improve the chance of recovery. And bring your tools back during stressful times, before pulling builds up.

Our guide on how to stop pulling your hair sets out practical tools you can use every day.

When should I get help?

Get support if pulling is upsetting you, taking up your time, or affecting your life, work, school or relationships. You don’t need to wait until it’s “bad enough”, and it’s never too late to start.

Many doctors and therapists have never worked with someone who pulls. 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.

If you’re a parent, start with The Parent’s Guide to Trichotillomania: understanding what your child is going through.

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

In an emergency, call 995 or go to your nearest emergency department.

• Samaritans of Singapore (SOS) — 1767 (24h)
• IMH Mental Health Helpline — 6389 2222

Questions people ask

Sources

1. Grant, J.E. & Chamberlain, S.R. (2022). Natural recovery in trichotillomania. Australian & New Zealand Journal of Psychiatry, 56(10), 1357–1362.
2. Neelapu, M. & Grant, J.E. (2025). Clinical characteristics of natural recovery in trichotillomania and skin picking disorder. Frontiers in Psychiatry, 16, 1681068.
3. Keijsers, G.P.J., van Minnen, A., Hoogduin, C.A.L., Klaassen, B.N.W., Hendriks, M.J. & Tanis-Jacobs, J. (2006). Behavioural treatment of trichotillomania: Two-year follow-up results. Behaviour Research and Therapy, 44(3), 359–370.
4. Falkenstein, M.J., Rogers, K., Malloy, E.J. & Haaga, D.A.F. (2014). Predictors of relapse following treatment of trichotillomania. Journal of Obsessive-Compulsive and Related Disorders, 3(4), 345–353.
5. Franklin, M.E., Edson, A.L., Ledley, D.A. & Cahill, S.P. (2011). Behavior therapy for pediatric trichotillomania: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 50(8), 763–771.
6. Sydney Children’s Hospitals Network (2026). Trichotillomania factsheet.