Trichotillomania and pregnancy are linked to highly individual changes in hair pulling and skin picking symptoms.
Background On Trichotillomania, Skin Picking, And Pregnancy
Trichotillomania and skin picking disorder usually begin around puberty and are more frequently reported in women than in men, which supports a possible role for hormonal influences on symptom severity. Despite this, very little research has examined how pregnancy and the postpartum period affect these body-focused repetitive behaviors.
Study Design And Population
To explore this gap, investigators recruited people from the general community who had trichotillomania and or skin picking disorder and who had experienced at least one pregnancy. Participants completed questionnaires about their perceived relationships between pregnancy, the postpartum period, and changes in symptom severity. This design allowed the researchers to capture real world experiences across multiple pregnancies and time points, although findings rested on retrospective recall.
Symptom Patterns During Pregnancy And Postpartum
Women were asked whether hair pulling and skin picking worsened, improved, or stayed the same during pregnancy and in the wider perinatal period. Some participants described clear exacerbations of trichotillomania and skin picking disorder during pregnancy or shortly after delivery, suggesting that for a subset of individuals these conditions may become more active at times of hormonal and psychosocial change. However, the majority of women reported either no meaningful change in these behaviors or noticeable reductions in hair pulling and skin picking during pregnancy and the postpartum period. Overall, the study indicates that trichotillomania and pregnancy, as well as skin picking disorder and pregnancy, are most often associated with stable or improved symptom patterns rather than universal deterioration.
Clinical Takeaways For Perinatal Care
For clinicians caring for pregnant or postpartum patients with trichotillomania or skin picking disorder, these findings highlight the importance of individualized assessment rather than expecting a consistent worsening of symptoms. Routine enquiry about symptom trajectories during pregnancy, the early parenting period, and previous pregnancies may help identify women who are vulnerable to exacerbations and those who experience improvement.
Future Research On Trichotillomania And Pregnancy
The work relied on retrospective questionnaires, so prospective studies that follow patients through pregnancy and beyond, and that incorporate biological measures related to hormonal and stress systems, are needed. Such research could clarify mechanisms behind worsening versus improvement and may ultimately support more personalized counseling and treatment planning for women managing trichotillomania and skin picking disorder during pregnancy and the postpartum period.
Reference: Grant JE et al. Trichotillomania, skin picking disorder, and pregnancy. Compr Psychiatry. 2025;144:152647.
