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Medical Marijuana and Trichotillomania

What Is Trichotillomania?

Trichotillomania is also known as compulsive hair pulling, which essentially sums up the disorder. Medical marijuana may be prescribed for this and other compulsive behaviors, though trichotillomania is more specific than other compulsive disorders for which medical marijuana is prescribed such as obsessive-compulsive disorder. Trichotillomania affects only the sufferer. These individuals will compulsively pull at their own hair until they experience unnatural hair loss. 

Individuals with trichotillomania typically present with symptoms before they turn 17. The chances of it occurring in girls are quadruple that of boys. Outward symptoms noticeable by others include bald patches, patches of stubbly hair and obvious pulling or twisting of the hair. The hair loss can appear with any hair on the body, including eyelashes and eyebrows. Sufferers will deny that they are doing it. However, they often feel driven to pull their hair out due to stress and feel release of that stress upon pulling. They may also have symptoms of depression, anxiety and other forms of self-mutilation. 

Treating trichotillomania with medical marijuana is not treating the hair loss or even the hair pulling itself, though treatment affects the behavior. It is treating the underlying cause of the compulsions and the hair pulling, which is typically anxiety, depression and low self-esteem. In many cases, indeed most cases, trichotillomania will go away within a year, even in very young children. However, it can also stay around for years or a lifetime. Therefore, medications to alleviate the symptoms can be necessary to preserve quality of life. Clearly, the loss of hair does nothing to assuage the negative feelings that lead to hair pulling.

Medical Marijuana and Trichotillomania

Medical Marijuana and Trichotillomania Research 

The typical treatments of trichotillomania in instances that require medication are anti-depressants. Aside from these side effect laden medications, there are very few options for medication. The same goes for other impulse control disorders. There is some research into use of medical marijuana and impulse control disorders that suggests it could provide relief from the impulse and the cause. Medical marijuana research has also delved into depression and anxiety. While research directly pertaining to trichotillomania is scant, research into the aforementioned areas of trichotillomania provide enough evidence to support pre-clinical and/or clinical testing on trichotillomania specifically. 

One open clinical trial that involved 14 women with trichotillomania, 12 of whom finished the trial. The authors of the study concluded that treatment with dronabinol -- a synthetic THC -- significantly reduced the impulsive behavior of the subjects. However, they also noted that the trial was open and there were few subjects. A larger blind, placebo-controlled study would provide results that are more conclusive. 

Medical Marijuana, Trichotillomania and Anxiety Research 

The underlying cause for individuals with trichotillomania can differ between sufferers. Therefore, the medical marijuana treatment may differ. If the underlying cause is anxiety, sufferers will have to find a strain or a derivative that alleviates their anxiety rather than increasing it. Studies have shown that medical marijuana can have either effect. What treatment works best for trichotillomania-related anxiety will depend on the sufferer's reaction to the medication. 

There is a wealth of anecdotal and clinical research that suggests medical marijuana increases or even causes anxiety. More research must be conducted on which components of marijuana appear to increase anxiety and which appear to decrease it. That may be the secret to discovering why medical marijuana can also have the opposite effect. In the abovementioned clinical study, medical marijuana had a positive effect on trichotillomania. It would be helpful in future studies for anxiety to be monitored and for the study group to include some individuals with notable anxiety and trichotillomania. 

Medical Marijuana and Depression Research 

According to a survey of 4,400 marijuana users, those who use marijuana experience fewer subjective symptoms of depression than those who do not. This shows that individuals with trichotillomania brought on by depression could be treated with medical marijuana. Even if the effects were purely subjective, which is unlikely, the relief and potential cessation of hair pulling would be real. In these cases, it is all about how a patient feels. Of course, placebo-controlled clinical trials would give more insight into whether medical marijuana treatment for depression can alleviate trichotillomania specifically.

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