Trichotillomania is stereotyped recurrent pulling of hair. The sites of hair pulling include scalp, eyelashes, eyebrows, axillary, body, or pubic. The hair may be lost in round patches or diffusely across the scalp. Hair pulling tends to occur in episodes, exacerbated by stress, or conversely sometimes worsened by relaxation (e.g., when reading a book or watching television). The person generally feels tension before pulling hair, which is relieved by the pulling. All other causes of hair loss, including medical and dermatological must be considered and ruled out before the diagnosis of trichotillomania is confirmed. Early detection remains the best form of prevention since it leads to early treatment. Decreasing stress in the environment might be beneficial, as stress may increase compulsive behavior.