Trichotillomania -Hair pulling disorder - #31725

Brahmi vati Medha vati One tablet twice daily after food with lukewarm milk Ashwagandha churna-1/2 teaspoon with warm milk at night do pranayama Yoga meditation regularly

Ayurvedic treatment consists of rejuvenation therapy, and external application on head to nourish hair and scalp Stress management also plays an important role Start with Amalaki rasayan 1-0-1 after food with water Ashwagandha churan 0-0-1tsp at bedtime with warm water Bhringraj ghanvati 1-0-1 after food with water Light massage with amla Brahmi oil on scalp. Do Nasya with Brahmi grith 2 drops in both nostril once daily D0 pranayam lom -vilom bhastrika bhamri 5-10mins daily twice Learn Rajyoga meditation and practice daily.

No need to worry dear,

You’ll definitely get relief 😌

Start taking these medications, 1.Saraswatarishta 20ml with equal amount of Lukewarm water just after having meal twice in a day. 2.Manasmitragullika 1-1-1 3.Brahmi cap.1-0-1 4.Kbir Sukoon tab.1-1-1

Follow up after 15 days.

Take care😊

Kind Regards, Dr.Isha Ashok Bhardwaj

1.Dimagdoshari tablets 2 tab twice daily 2.Brihat vatchintamani rasa 1 tab twice daily with honey 3.Ashwagandha churna 1 tsp twice daily with warm milk 4.Jatamansi capsule 1 cap at bedtime

✅ Do: - Abhyanga: Daily warm sesame oil massage (especially scalp and feet) - Nasya therapy: 2 drops of Anu Taila in each nostril daily - Pranayama: Bhramari, Anulom Vilom (10 mins daily) - Yoga: Supta Baddha Konasana, Balasana, Viparita Karani 🚫 Avoid: - Overstimulation (screens, caffeine, loud environments) - Skipping meals or sleep

- Tulsi tea + journaling in the evening to calm mental chatter - Grounding rituals: Foot massage with Brahmi oil before bed - Visualization: Imagine cooling lunar energy flowing from scalp to feet during meditation

Panchakarma - Shirodhara: Warm oil stream on forehead to calm obsessive thoughts - Basti therapy: Medicated enema to pacify deep Vata imbalance

hello sushma ,

Trichotillomania means your brain gives you a strong urge to pull hair. It’s common, it can feel out of control, and it often gets worse with stress or anxiety. Stopping the pills you tried doesn’t mean you’ve failed many people need a mix of psychological tools, safe medicines, and self-help strategies to get better.

The goal here is:

1. reduce the urge, 2. prevent new hair loss, and 3. help hair regrow step by step.

Treatment plan :

Internal medicines (supportive take only after discussing with your treating doctor):

(These are supportive they help anxiety, sleep, and neural recovery; they are not a guaranteed cure.)

1.N-Acetylcysteine (NAC) — 600 mg twice daily (total 1200 mg/day) for 8–12 weeks, then review. Some studies show reduced hair-pulling urges. Start only after checking with your psychiatrist/doctor. 2.Brahmi (Bacopa) extract — 300 mg once daily (take with food) — helps concentration and calm. 3.Ashwagandha (Withania) extract — 300–500 mg at night, if anxiety/sleep are a big issue. 4.Jatamansi (Nardostachys) — 125–250 mg at night if you have marked restlessness or sleep trouble.

If you are on (or may restart) any psychiatric drugs, tell the prescribing doctor before starting NAC or herbal extracts to avoid interactions.

3) External/topical (for hair & scalp)

1.Bhringraj oil (or coconut + bhringraj) gentle scalp massage 2–3 times/week at night to encourage hair strength. See a dermatologist about minoxidil or other topical hair-regrowth options if needed (they can advise when to start safely).

Behavioural & practical measures (must-do; these work best with medicines)

Habit Reversal (HRT) — this is the single most effective psych approach. Basic steps you can start immediately: Awareness training: notice the exact triggers and moments you pull (time of day, feelings). Competing response: when urge comes, perform a safe incompatible action for 1–2 minutes (clench fists, squeeze a stress-ball, hold a small object). Stimulus control: cover hair with a scarf/hat, wear a wristband, keep nails short, use gloves or adhesive bandage on fingers at home. Mindfulness & grounding — 5–10 minutes daily (breathing + body scan) to drop reactivity to urges. Replace the habit with a sensory replacement (fidget toy, worry beads, textured cloth).

Investigations / baseline checks (to do before starting medicines like NAC)

CBC, LFT, RFT (basic safety labs) Thyroid profile, Vitamin B12, Ferritin, Vitamin D (deficiencies can worsen hair loss and mood)

If you are on other meds, get current drug list and a quick review from your psychiatrist.

Psychiatrist or clinical psychologist trained in CBT/HRT - urgent priority for structured therapy. Dermatologist — for hair-loss assessment and regrowth treatment. Your primary doctor — to check labs and approve NAC/herbal supplements safely.

You may notice urges reduce in 4–8 weeks with NAC + HRT; meaningful hair regrowth can take 3–6 months. Consistency matters small daily practices add up.

Two quick questions (so I can tailor further) Are you currently seeing a psychiatrist or therapist now? Any pregnancy, breastfeeding, or major medical problems / liver or kidney disease?

You’re not alone in this many people improve considerably with the right combination of therapy, a safe supplement like NAC (under medical advice), and scalp care. Be kind to yourself: every small step away from pulling matters.

Warm regards, Dr. Karthika

Addressing trichotillomania through Ayurveda involves understanding the underlying imbalance in your mind-body system, specifically focusing on the mental and emotional triggers involved. According to Ayurvedic principles, this condition can be influenced by an imbalance in both Pitta and Vata doshas. Pitta may contribute to the irritability and agitation you feel, while Vata may cause restlessness.

A potential first step is implementing a routine that pacifies both Vata and Pitta. Begin with a daily practice of Abhyanga, gentle self-massage using lukewarm sesame oil, followed by a warm bath. This can help calm the nervous system and soothe skin irritation. Perform it in morning to start your day balanced or in evening if that suits your routine better.

Dietary changes can also be crucial. Focus on including grounding, nourishing foods like whole grains, sweet fruits, and cooked vegetables. Avoid excessive spicy, sour, and pungent foods as they can worsen Pitta. Instead, favor sweet, bitter and astringent tastes. Incorporate cooling herbs like coriander and fennel in meals to balance Pitta, while including warm spices like ginger and cinnamon to stabilize Vata.

Mind-calming practices such as meditation or pranayama, specifically Nadi Shodhana (alternate nostril breathing), could be beneficial. Engaging in such practices thrice a day, even just for 5-10 minutes each session, may help manage stress levels.

Herbal support from Ashwagandha can be considered for its adaptogenic properties, offering stress relief and mental balance. Before incorporating it into your routine, consult with an Ayurvedic practitioner aligned to assess dosage pertaining your specific condition.

Lastly, spending time in nature or engaging in activities that bring joy without overstimulation like gentle yoga or art, can assist in channeling your energy more positivity. Consistently practicing a peaceful bedtime routine and ensuring 7 to 9 hours of good quality sleep assists the mind to recover and resist impulses. By integrating these measures into your daily routine, you can potentially achieve balance and reduce the urge to pull hair.

Given your history with conventional medication, it’s essential to work closely with an Ayurvedic practitioner to personalize recommendations tailored to your body’s needs and ensure no adverse reactions occur.

Trichotillomania can certainly be a challenging condition to manage, especially when medications haven’t worked as expected. In Siddha-Ayurvedic practice, we consider this condition often reflecting an imbalance in the mind-body connection and specifically an agitation of the vata dosha, which governs nervous system and mental impulses.

First and foremost, focus on grounding vata. It’s vital to establish a daily routine that stabilizes and nourishes. Begin with abhyanga, or self-massage, using warm sesame oil. This can calm the nervous system and reduce compulsive behaviors. Aim to do this at least three times a week in the morning before a warm bath or shower.

Incorporate herbs that support mental balance and reduce stress. Consider Brahmi (Bacopa monnieri) and Jatamansi (Nardostachys jatamansi) as they are known in Ayurveda to bring tranquility to the mind. They can be taken as powder, about 1/2 to 1 teaspoon twice daily mixed with water or milk. It’s always best to consult with a local Ayurvedic practitioner for proper dosing and evaluation.

Diet also plays a crucial role. Try to eat warm, cooked meals with mung dal, rice, and seasonal vegetables to keep digestive fire, agni, balanced. Avoid too much raw foods or caffeine, which can exacerbate vata. Incorporate sweet, sour, and salty tastes, all of which pacify vata dosha.

Engage in relaxation techniques like yoga or pranayama as well, particularly nadi shodhana (alternate nostril breathing). These practices can help reduce stress and enhance focus away from pulling urges.

It’s advisable to seek personalized guidance from an Ayurvedic or Siddha practitioner who can consider your unique prakriti for tailored advice. Remember, if at any stage your condition imposes severe distress or harm, seeking immediate professional psychological support is vital.

HELLO SUSHMA,

GOALS OF TREATMENT -calm the agitated mind (reduce urges) -reduce anxiety/stresss-common trigger -heal + nourish scalp to promote regrowth -build daily rituals and coping skills to prevent relapse

INTERNAL SUPPORT

1) BRAHMI VATI= 1 tab twice daily for 12 weeks to reduce impulsivity and anxiety

2) ASHWAGANDHA CAPSULES= 1 cap twice daily with warm milk for anxiety and resilience

3) SHANKAPUSHPI SYRUP= 2 tsp twice daily for calming sleep, impulse control

4) TRIPHALA CHURNA= 1 tsp at night with warm water for gentle detox/ antioxidant to support hair health and digestion

EXTERNAL THERAPIES

1) Daily scalp oil massage with sesame oil infused with bringaraj + amla + vrahmi= 20-30 min before shampooing 3-4 times / week =nourishes follicles and is a calming ritual

2) NASYA= instill 2 drops of brahmi ghrita in each nostril in morinng =improve mental balance,

BEHAVIOURAL + LIFESTYLE

HABIT REVERSAL TRAINING= first line for trichotillomania =pair ayurvedic measures with psychotherapy

DAILY ROUTINE= regular sleep, simple warm nourishing breakfasts, avoid stimulants, reduces screen time in evening

MINDFULNESS/ BREATHING (5-10 min twice daily)= deep diaphragmatic breaths or alternate nostril breathing to reduce urge intensity

RED FLAGS AND IMPORTANT CAUTIONS -Don’t abruptly stop psychiatric meds without your psychaitrist- discuss patches/changes with them -If urges arre causing severe distress, self harm, or you feel out of control, seek immediate mental health support

THANK YOU

DR. HEMANSHU MEHTA