Does hair grow back after trichotillomania?

The short answer: if a hair follicle has not been repeatedly damaged, it can usually produce hair again once pulling from that spot stops. Years of repeated pulling from the same follicle increase the risk of scarring and permanent hair loss there, which a follicle cannot recover from. Between those two outcomes is a wide, common middle ground: regrowth that is slower, finer or different in texture at first, and that improves over further growth cycles.

What determines whether a follicle recovers

Hair grows in cycles, and the structure that produces each hair, the follicle, sits in the skin whether or not a hair is currently growing from it. Pulling itself does not usually destroy a follicle instantly. What causes lasting damage is repeated trauma to the same spot over a long period, which can lead to scarring. A scarred follicle stops producing hair, and that loss is permanent. A follicle that has been pulled from but not scarred generally can start producing hair again once it stops being pulled.

What regrowth commonly looks like at first

People who stop pulling from a long-affected area commonly describe the first regrowth as finer, sparser or a different texture than before, sometimes a different color in older hair follicles. This is a widely reported pattern among people recovering from trichotillomania rather than a guaranteed clinical outcome for everyone, and advocacy and education resources describe it as a normal early stage rather than a sign something has gone wrong.[1] Texture and thickness typically become closer to normal as a follicle completes more growth cycles without further pulling.

Areas that behave differently

Scalp hair, eyebrows and eyelashes have different growth cycles and sit in skin of different thickness, so they do not necessarily behave the same way. Eyelash and eyebrow follicles are smaller and are commonly described as more sensitive to repeated pulling, which is one reason those areas are often slower or more uncertain to fully recover than scalp hair after the same number of years of pulling. If eyelash or eyebrow pulling is your main concern, see our dedicated guide for area-specific detail.

Why stopping, not pulling less, is what allows regrowth to start

A follicle that is pulled from occasionally cannot complete a full growth cycle any better than one pulled from constantly, if the same spot keeps getting hit. Reducing frequency is real progress and worth recognizing, but regrowth in a specific area generally needs that area to stop being pulled from altogether for a sustained period. This is one reason awareness-based approaches, including habit reversal training, focus on noticing and interrupting pulling as early in the sequence as possible rather than only on managing it after the fact.[2]

A healed follicle does not need a perfect week. It needs enough consecutive time without being pulled from to finish a growth cycle.

When to see a dermatologist

See a dermatologist if a bald patch shows no signs of regrowth several months after pulling there has stopped, if the skin in the area looks shiny, scarred or unusually smooth, which can indicate permanent follicle loss, or if you are not sure whether hair loss is from pulling at all. Patchy hair loss can also have other causes, including alopecia areata, which looks similar at first glance but has a different cause and treatment; our guide to telling them apart covers the visible differences a clinician looks for.

Common questions

Does hair always grow back after trichotillomania?

Often, but not always. If a follicle has not been repeatedly damaged, it can usually produce hair again once pulling from that spot stops. Follicles pulled from for years, especially the same spot, are more likely to scar and stop producing hair.

How long does regrowth take?

Timelines vary by area and by how long and how repeatedly a spot was pulled. Scalp hair regrowth is commonly discussed in terms of months rather than weeks, and eyelashes and eyebrows, with shorter growth cycles but more delicate follicles, can behave differently.

Why does regrown hair sometimes look different?

People commonly report that early regrowth is finer, sparser or a different texture than the hair that was pulled. This is a commonly reported pattern rather than a guaranteed outcome for everyone, and it often evens out as a follicle has more growth cycles.

When should I see a dermatologist about hair loss from pulling?

See a dermatologist if a bald patch has not started to regrow months after pulling there has stopped, if the scalp looks shiny, scarred or inflamed, or if you are unsure whether the hair loss is from pulling at all rather than another cause.

References

1. International OCD Foundation. "Encouraging hair growth after trichotillomania." 2024. IOCDF.
2. Lee MT, Mpavaenda DN, Fineberg NA. "Habit reversal therapy in obsessive compulsive related disorders: a systematic review." Journal of Behavior Therapy and Experimental Psychiatry. 2019. PubMed.