Category Archives: Trichotillomania

How Lucinda Ellery has helped me overcome a lifetime of hair-pulling.

By Anna Bruning

The day, 20 years ago, I decided to finally request a meeting to discuss my hair loss at the Lucinda Ellery Consultancy ranks among one of the most important in my life.

It had taken me years to get up the courage to make that call to ask for the help with my hair I desperately needed – and to override that little voice within that told me no one and nothing would be able to undo the lifetime’s damage I had done to my follicles. And that I didn’t deserve it. So there!

I had been living with the secretive and ruinous desire to pull out my own hair since the age of 13. I craved that rush of serotonin release in response to a childhood of beatings, vicious putdowns and bullying both at home and in school. But of course the pulling that gives relief from emotional pain also creates it anew, with each fresh cycle of destruction. After all, hair is literally a woman’s crowning glory and there I was, turning mine into a patchy, scraggy mess. Desirable me just when I should be dating? Not exactly.

It is impossible to say what hurt more, the pulling or the realisation that I had just freshly re-sabotaged my brave, struggling follicles under constant attack.

Each time something upset me – and, like for most of us, things do, almost daily – my busy little fingers went cotton-picking straight up into my roots for that sharp nerve twinge, followed by sweet release.

By the time I made that call to the Lucinda Ellery Consultancy there was very little hair left on my head. It had become impossible to hide the large bald patches, even behind the permanent up-do that was my calling card. My partner said he loved me, but I didn’t love myself.

My hair issues hurt my confidence – and my career

My hair story definitely hurt my professional life. Rival colleagues sensed my secret vulnerability. People used to sneak up behind my desk and try to swiftly undo my hairclips.

“Go on, Anna, let your hair down,” was the bullying ‘joke’, fully aware that something was stopping me. For my birthday one year my office designed a collage card featuring my face topped with allegedly witty hairstyles – from Marie Antoinette-like tall-ship wigs to punk Mohicans, from Jennifer Aniston’s iconic ‘Rachel’ style to cornrows, an Afro, dreadlocks and more. Very amusing. Not. Needless to say, it all added to me feeling super unconfident. I never even considered putting my naked head above the parapet for promotion.

Now, after 30 years of unstoppable self-harm – giving in to the overwhelming craving for warm release after the pain of pulling, then knowing I had yet again destroyed weeks’ or months’ worth of hopeful regrowth – I was on the cusp of transformation.

Nervous ahead of the first consultation

I was shaking when I drove to meet the Lucinda Ellery team for the first time, unsure they could help me. Jumpy, I scraped the entire length of my brand new Mercedes. The car proved more expensive to fix than my hair has ever been!

The minute I was buzzed into the Consultancy all that fear dropped away. The salon is gorgeous: a bright, beautiful, safe, warm and welcoming space. I was greeted with genuine care. No one was judging. Everyone was there to help. Privacy and discretion guaranteed.

Best of all, I was told with sincerity and warmth that mine was not the worst case Lucinda Ellery had seen. In fact, I had plenty of natural hair on my head for them to work with.

I also heard for the first time that hair-pulling is surprisingly common. I had researched my condition and had come across the term Trichotillomania. Have to say, still not thrilled with the ‘mania’ element of the term that is cobbled together from various Greek medical words. And I had no idea how many women might suffer from this destructive impulse. I was pretty sure I was the only one. Back in the day, that sort of information simply wasn’t out there.

The salon had the reassurance. Although just under 2% of us worldwide have the condition, more commonly known as TTM, they explained that it is more prevalent among females. You just feel alone because we don’t exactly see TTM women power-posing their way across the planet, gleaming scalps signalling our sexual allure and feminine mojo. And I wasn’t mad. I was merely one of those (mainly starting in childhood, in response to events we cannot control) who find release in hurting their own largest and nearest vital organ, their skin – by worrying at it and its variations. Girls and boys skin-pick, nail-bite, hair-pull, cut, ink, score and pierce their skin. Taking it out on ourselves provides relief from circumstances we cannot alter.

Lucinda Ellery explained the various practical hair solutions the salon offers. It was made clear it was entirely my choice as to which system might best serve me.

I decided on the Intralace, where a fine mesh is placed over your own hair which is then lifted through it and attached to it. Hair is then added in any colour you desire. You can stick with your own shade or have your hair tinted to match what you’ve selected instead. The result is then styled very naturally in the shape and length you desire.

Normal everyday activities will not disturb the integrity of the Intralace, because it is attached to your own existing hair base. It will never fly off in wind, rain, gales, during sport, or while you’re getting romantic. Moreover, the system prevents you pulling or scratching your own hair underneath, giving your follicles a chance to heal and regenerate.

I could participate in daily life again without worrying that the Intralace would desert my head at the hint of a breeze or that scalp would show through come the teeniest drop of rain. No one would ever know, unless I chose to tell.

My dream hair

In contrast to previous salons where stylists had been hoity about being asked for a hot look – sorry (so not sorry!), your thin, miserable strands won’t achieve that, fnarr fnarr! – here I had been encouraged to bring in photos of what I dreamed of.

I wanted to go back to the long blonde hair of my early teens (before I started pulling). It is now me. I always ask for dark roots, to indicate healthy regrowth. My own hair continues to grow strongly, if inevitably patchily, underneath.

My first day back at work there were plenty of comments – mostly genuinely complimentary, but with the less civilised colleagues (every office has ’em) wondering out loud why I looked so different.  As time went on, any unusual interest in my appearance died down. I didn’t stand out for all the wrong reasons. The more confident new me finally had the courage to aim for – and attain – a senior professional role.

It’s your hair, you paid for it

After leaving the salon with your new hair, you will need to adjust. As I headed home wearing my first Intralace, that nagging inner voice told me my lovely blonde locks looked obviously fake. My new hair felt too thick, too blonde, too obviously added on. It didn’t feel like me. I was used to doing without.

I was warned the system initially might feel too closely fitted – but of course your own hair, which anchors it, continues to grow out, millimetre by millimetre, day by day. In just days that tightness definitely eases.

In fact, I enjoyed the Intralace being so deeply entwined with my own hair. I knew it wouldn’t come off unless I went back to the salon to beg them to remove it, and that was never going to happen.

It took me just one evening to get over any lingering doubts. By the next morning my Intralace felt as if it was entirely my own, as if I’d never been without it. With my mind basking under a flatteringly full head of hair, it reset to an entirely more positive view of myself and the world.

Best of all, no one would ever know. Unless I choose to tell, as I am telling you now.

© Anna Bruning

Anna Bruning is a former Sunday Times journalist. She has been a client of the Lucinda Ellery Consultancy for 20+ years

If you’d like to speak to us about hair pulling please call one of our studios or use our Trichotillomania Contact form.

The real effects of social media on young women today

Pressures on teens due to social media are a real, and often surreal, challenge in society today. 95% of teens have access to a smartphone, and 45% say they are online ‘almost constantly’. And while the benefits of social media are numerous, there are significant downsides including bullying and pressure to live up to the perfectly crafted images of friends and influencers.

According to a recent study, 24% of teens said that social media was a negative in their lives, with comments including:

  • “Gives people a bigger audience to speak and teach hate and belittle each other.” (Boy, age 13)
  • “People can say whatever they want with anonymity and I think that has a negative impact.” (Boy, age 15)
  • “Because teens are killing people all because of the things they see on social media or because of the things that happened on social media.” (Girl, age 14)

When these additional pressures are added to existing ones the effects can be difficult to handle.

Jordan’s Story of Hair Pulling

One such story is Jordan, a 14-year old who has been battling Trichotillomania or TTM (an impulse control disorder where one pulls out their own hair and is often triggered by anxiety) for three years. TTM has been known to impact 2.5 million people in the US.

For Jordan, TTM began as she was entering 6th grade and she experienced severe anxiety over getting good grades and being popular with her classmates. As a way to cope with the pressure to be perfect she began pulling her eyebrows, lashes and hair on her head, leading to bald spots that she needed to cover with hair pieces and headbands.

She felt an overwhelming anxiety about the pursuit of being perfect. Looking at the likes of Instagram and these staged perfect lives of young women her age just added to this anxiety – as it does for so many these days.

She was bullied, told she looked like a boy, and was not accepted by the “popular” crowd whose acceptance she so desperately sought.

After her mother heard about Lucinda Ellery and the Intralace System, where mesh is integrated into existing hair and in doing so creates a barrier to pulling, she knew this was an avenue she needed to pursue; she booked an appointment and hours later Jordan emerged with a full head of hair and renewed confidence.

Because of the mesh integration, pulling is also no longer possible, so TTM is essentially stopped in its tracks. Jordan then began a new school and learnt to let go of the concept of perfection.

Jordan stated “it is hard being a young woman with added pressures to be society’s definition of perfect. The anxiety this caused me ultimately manifested in me pulling out my hair but equally I have friends who starve themselves or self-harm; all ways they deal with the increasing social pressures we face these days”. Jordan adds “with my new restored confidence and the Intralace acting as a barrier I can now deal with feeling great in my own skin and defeating TTM!”

Jordan before having the Intralace fitted
Jordan before having the Intralace fitted
Jordan after having the Intralace fitted
Jordan after having the Intralace fitted

before and after
Last week, we continued a new tradition we’ve had in place for the past few years by hosting ‘International No Pulling Week’.

The week looks to raise awareness of a condition called Trichotillomania, or TTM for short, which affects around 110 million people worldwide. We think it’s staggering that so many people around the world are touched by TTM yet so few seek treatment for it – latest figures estimate that this is less than 1 in 10. The condition is actually more common than bulimia and No Pulling Week helps us to raise awareness of this little-known problem.

For those of you who aren’t too sure what TTM is, it is a disorder where sufferers feel compelled to pull out hair from their head, eyelashes, or even body to deal with personal emotion, stress, anxiety. It can be described as a ‘coping’ mechanism and, as I like to call it, a method of ‘self-calming’.

I have worked for 25 years to find ways to lessen the impact that TTM has on women’s lives. Like any condition of this kind, it is worse when sufferers are feeling anxious, stressed or lacking in self-confidence; so by having fabulous looking hair, we can try and minimize these feelings and offer hair styling and support in a safe environment.

Katie Neiman
Katie Neiman

Therefore with all the above in mind, we wanted to ensure International No Pulling Week got the attention it deserved in the media – you may have seen some of the pieces on our Twitter and Facebook channels but we were thrilled with the debate it raised. We kicked off the week with two pieces in Ok and Look, with the latter featuring one of our ladies who we’ve been working with for a while – Katie Neiman telling her story about how she first started pulling when she was at university. She also told her inspirational story on the Daily Express Online.

Phoebe Ottomar
Phoebe Ottomar

Another client who sought our help was Phoebe Ottomar – just 19 years old, Phoebe started pulling out her hair at the tender age of 8, and her incredibly brave story was featured on the likes of the Mail Online, Cosmopolitan online as well as in Phoebe’s local newspapers.


A very special mention also needs to go to Charlie Suggett – aged 25, Charlie came into our London studio to film a piece for Channel 5 News. The health reporter, Catherine Jones, spent a few hours at our studio, interviewing Charlie and hearing how TTM had affected her, while I talked about how our pioneering Intralace system can make a difference – if you haven’t seen the piece already, make sure you watch it here.

While International No Pulling Week has now drawn to a close for another year, our work to continue to help women with Trichotillomania continues. As I’ve outlined, for many women, the first, and biggest step is admitting to themselves that they have a problem so if anyone reading this thinks they might suffer from TTM or knows someone who needs help or advice, don’t suffer in silence – please visit the Trichotillomania pages on our main site.


Some Basic Facts

Trichotillomania is a condition where someone has the irresistible urge to pull their own hair out.  It affects up to 2% of the population and is more common in females.   It is also known as TTM, Trich or Tricho.

What are the signs?

One of our clients with TTM
One of our clients with TTM

Hair pulling commonly starts at the ages of 12 or 13 and can coincide with puberty.  There are varying degrees of severity.  The most common areas to pull from are behind the ears and the crown or top of the scalp.  Some people will continuously pull from the same areas and others will move around the scalp.

Visible hair loss is inevitable from repeated pulling but people with Trich tend to become masters at disguising it by having their hair in a certain style or by using make up to cover the patches. However it’s very hard to manage the pulling without proper support, so in many cases the area of pulling can increase dramatically over a period of time.

Varying degrees of severity of TTM

Everyone is different – some pull regularly every day while others may have longer spells between pulling. Some pull from specific areas and if done frequently this can lead to a completely bare patch in one place while the rest of the head is unaffected. Some start in one place and gradually work outwards so that a larger and larger area becomes sparse, or in extreme cases, bare. The more intense the pulling the more likely that permanent damage can be done. While the scalp is the most common place, there are some who pull from their eyebrows and eyelashes – either instead of or as well as the scalp.

Awareness – public and professional

For a long time, little was known about TTM and finding out about it was difficult. Most people hadn’t heard of it, even doctors, and many sufferers thought themselves unique. Thankfully in recent years there has been much more information available and more and more people are aware of it.

It is often grouped with Obsessive Compulsive Disorders, though experts still argue about that. The medical profession in general seem to have a better awareness and understanding. There are now forums on the internet offering information and advice, and many sufferers are posting videos on sites like Youtube where they describe their condition and the ups and down of fighting it.  It has been written about in various magazines and newspapers and has been featured on TV shows like This Morning and Embarrassing Illness.

However despite this increased awareness,such is the isolating effect of it that most people with Trich are really shocked to discover that they are not the only one suffering from this condition, and are often very surprised to find out that it actually has a name.

There is unfortunately a degree of secrecy with trichotillomania – people are too embarrassed to mention it to anyone else and their friends or family may just assume that they have alopecia.  It’s rare for someone to openly discuss their hair pulling. We’re frequently told by new clients that we are the first people they’ve ever talked to about it, and that step alone is often a source of relief to them.

Article in New magazine about two of our clients
Article in New magazine about two of our clients

When, Where and Why?

It is usually more likely that the hair pulling happens in private –  so either in the privacy of the bedroom when no one else is there or in the bathroom where the door can be locked.  People with trich will often say that they find themselves in a trance-like state where they have spent possibly a number of hours pulling their hair out without even realising. Sometimes this happens when they’ve been reading or studying, and they only become aware of it when they see a clump of hair next to them.

They may say that it is comforting – there is a release of stress when the hair is pulled.  Though it doesn’t necessarily happen only when you are stressed or unhappy – it can also happen when you are feeling quite relaxed – but the feelings post-pulling are always very negative.  You don’t want to do it but you just can’t stop.

In some cases there is an underlying problem that triggers the first pulling event – emotional problems with family such as a death or a divorce, or problems at school or work are often mentioned – but in others there is no obvious cause. But once started the urge to pull again becomes irresistible.

Having a ongoing bad hair day

Having trich tends to really rule your day.  You’ll have to spend a considerable amount of time arranging your hair to cover the hair loss, so often clients will mention that they have to get up much earlier than normal so that they have time to do the tedious task of disguising the bare patches.  You will avoid many social situations – sleepovers are difficult and the prospect of that special someone touching your hair can fill you with dread.  Any activity which means getting your hair wet is a big no no.  A simple thing like the subject of hair in conversation can be really difficult.  Some people will even adapt their sense of fashion to accommodate wearing a hat – they don’t really want to wear a baseball cap but they need it to cover the hair loss.

My child has it – What do I do?

If you suspect your child is pulling their hair out then a telling off is not appropriate. They may already want to stop but simply can’t. They need your support and help, both personally and in order to find professional advice.

Try to be aware of how long they are spending alone in their bedroom, perhaps suggest they study or watch TV in the kitchen or sitting room. You may notice that their hands are constantly in their hair so use a distraction to get their hands away from their hair.

If your child is very young and you suspect they are pulling their hair then put some Vaseline in your hands and rub it through their hair.  This makes the hair slippy and very hard to grip on to.

Bear in mind that someone will trich will have mastered how to pull their hair with their nails being a certain length so for example if someone has always had short nails and they are suddenly longer they will find it very difficult to pull the hair. So if appropriate you may want to change their nails.

What can be done to help?

The first thing to realise is that while it can seem impossible to begin with it’s entirely possible for the pulling to be effectively managed and stopped with the right help.

A visit to your GP would be the first step.  Hopefully your GP will be aware of the condition but if not they may take the opportunity to do some research on the subject. If they aren’t aware then ask to be referred to a specialist. Thankfully it’s very rare for a GP not to be sympathetic but if you find it’s dismissed as not being important then don’t be afraid to see another doctor.

Cognitive Behavioural Therapy is commonly reported to greatly help control urges and help with managing TTM. Your GP may refer you to one or you can find one yourself. (You may find useful for this.)

You should first check that the Therapist sees clients with Trich (some do and some don’t).  A number of sessions with the Therapists would normally be recommended.  The success of any type of treatment will of course be governed to a degree by the attitude of the person with the problem.  If they are willing to be helped then the chances are it will work but if they are not willing then it is unlikely to be successful.

Our own approach

Sufferers who come to us are given a number of techniques including relaxation and distraction, and are offered the chance to take part in a “buddy” system and social support meetings. We’ve also found that our Intralace System can be a valuable tool.

The Intralace has two ways of working for clients with TTM:

  • It will disguise any areas of hair loss – helping the client to look and feel good about themselves
  • It helps as a physical barrier to the pulling site – preventing the hands from reaching the hair roots and gradually breaking the habit of doing so

It is not a cure but it makes access to the areas of pulling very difficult as the scalp is covered with a mesh which in turn is covered with hair. This gives the scalp a chance to recover and for regrowth to occur if there is no permanent damage.

There is a tremendous sense of normality associated with using the system – you have a full head of hair again so it certainly reinstates some of that much-needed self esteem. And that sense of normality coupled with the physical prevention from pulling can give you the space you need to help break the cycle.

Charlotte before having an Intralace fitted
Charlotte before having an Intralace fitted
Charlotte after having an Intralace fitted
Charlotte after having an Intralace fitted


Many people with Trichotillomania will say that trying to manage their hair pulling without any support is extremely difficult, but the facts are that many do become “pull free” and move on with their lives – because they found the right help.

It’s best to take control of Trich rather than it controlling you – and asking for help is the first step.

Further information

Our main UK website has further information and videos about Trichotillomania including the Channel 4 documentary, Girls on the Pull.