Other signs of trichotillomania Besides repeated hairpulling, other signs of trichotillomania may include: Feeling tense before pulling out your hair or if you try to resist the urge to pull Feeling relieved, satisfied, or pleased after acting on the impulse to pull hair Distress or problems at work, at school, or in your social life due to hairpulling Avoiding situations where people might find out that you pull hair or have hair loss, like sleepovers, swimming, going outside in windy weather, hair salons or barber shops, changing rooms, or sexual intimacy with a partner Conflicts or tension with your friends or family related to pulling Irritated or sore skin from pulling or a tingling feeling or itch that makes you want to pull Scars or damage to your skin, scalp, or hair follicles Rituals like chewing on the hair you pull out, inspecting the hair root, twirling the hair, putting the hair between your teeth, or eating hair A preference for certain types or textures of hair Changes to how you look because of hair loss Bare patches where your hair has been pulled out Pulling fibers from blankets and clothing or hair from pets or dolls If you have trichotillomania, you could also have other body-focused repetitive behaviors, like nail biting, skin picking, or chewing on your lips or cheeks

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Tobacco companies also poured money into, and built relationships with, Black institutions
Nursing homes and senior living facilities