Trichotillomania and traction alopecia are chronic habitual disorders characterized by repetitive pulling of hair that results in alopecia. They are commonly observed in children and adolescents but may present in adults due to occupational or traditional behavioral patterns. Trichotillomania (hair‐pulling disorder) has been described more than a century ago, but we still have very limited data about its etiology and treatment. It is classified under the obsessive‐compulsive and related disorders along with hoarding disorder, skin‐picking disorder (excoriation) and body dysmorphic disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5; American Psychiatric Association, May 2013). Traction alopecia is defined as loss of hair caused by repetitive or continuous and prolonged tension applied to the hair, usually on the scalp periphery and associated with mechanical traction of hair due to occupational behavioral patterns such as ballerinas or traditional behavioral patterns of hairstyles that cause tension. We aim to overview the clinical and diagnostic features of trichotillomania and traction alopecia and review the therapeutic options of these disorders in this chapter.
Part of the book: Hair and Scalp Disorders
Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy that affects women from puberty to whole reproductive life. Diagnosis and treatment of PCOS is not clear. Polycystic ovary syndrome is a multisystem disease that involves dermatologist examining patients with clinical hyperandrogenism and/or biochemical signs of hyperandrogenism; gynecologist examines patients with oligo-ovulation or infertility. The management of PCOS should be tailored to each woman’s specific symptoms, fertility-related implications, and metabolic disorders. Pharmacologic treatment is not necessary for all patients with PCOS, also lifestyle changes like exercise, weight loss, and diet are effective for treatment. Lifestyle changes are often recommended as first-line treatment for PCOS to benefit general health. Topical nonhormonal therapies and laser hair removal may be effective for cutaneous symptoms like acne, hirsutism, and androgenetic alopecia in the PCOS population and are useful first-line agents. Some pharmacological agents (anti-androgens) are used to control the dermatological symptoms of hyperandrogenism. Metformin is useful for metabolic and glycemic anomalies and for the treatment of menstrual irregularities, but less effective than antiandrogens for the treatment of both hirsutism and acne. The aim of this study is to talk about unclear topics in PCOS and multidisciplinary approach to patients.
Part of the book: Debatable Topics in PCOS Patients