Criterion A requires that hair pulling lead to hair loss, although individuals with this disorder may pull hair in a widely distributed pattern (i.e., pulling single hairs from all over a site) such that hair loss may not be clearly visible. Individuals with trichotillomania have repeated attempts to decrease or stop hair pulling (Criterion B). Criterion C indicates that hair pulling causes clinically significant distress or impairment in functioning. 

University of Illinois at Chicago

1. Recurrent pulling out of one’s hair, resulting in hair loss.
2. Repeated attempts to decrease or stop hair pulling.
3. The hair pulling causes clinically significant stress or impairment in social, occupational, or other important areas of functioning.
4. The hair pulling or hair loss is not attributable to another medical condition (e.g., a dermatological condition).
5. The hair pulling is not better explained by the symptoms of another mental disorder (e.g., attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder). 

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