Category Archives: Regrowth


Reflections on Skin Picking and Hair Pulling - OCD Center of Los Angeles

Reflections on
Skin Picking and Hair Pulling


Suffering usually relates to wanting things to be different from the way they are.

~ Allan Lokos



Everybody suffers. But much of our psychological suffering occurs as a result of our beliefs about how we think life “should”be, or how we would ideally like it to be. Often, it is our over-attachment to these beliefs that turns normal, everyday pain and discomfort into true suffering.

If you have Skin Picking Disorder or Trichotillomania, you may suffer needlessly as a result of this type of over-attachment to certain beliefs. An unwanted blemish or hair (or event or feeling) is not as you wish it would be, which leads to distress, which in turn leads to a picking or pulling episode. This not only worsens the physical consequences of these conditions, but leads to more psychological suffering in the form of hours (or days) of self-loathing during which you spend a great deal of time negatively evaluating yourself and your behavior.

Common negative thoughts might include “I should have been able to overcome the urge to pick or pull”, or “I look so ugly”, or “I am inadequate” or “I am hopeless”. Over time, and with much repetition, these types of thoughts become internalized into an overall negative belief system you have about yourself, which only increases your suffering.

The long-term goal of recovery is to develop more psychological flexibility by making room for all of the imperfections of real life, thus lessening the emotional suffering you experience. Life will never be 100% free of pain and suffering.  In fact, life is full of unavoidable pain, such as the pain we experience with serious illness or injury, or the death of a loved one. However, much of our psychological pain is self-created by thoughts and beliefs that are unhelpful, and which ultimately lead to picking and pulling setbacks.

If you do not measure up to what you think is acceptable, you may ultimately inhibit and prolong your recovery. Alternatively, by accepting all of life, including your imperfections, you will reduce your suffering, and move further down the road of recovery.


1) How often do you get stuck in the trap of judging yourself and your picking and pulling behavior, and not allowing room for imperfection?

2) What specific thoughts do you have after a setback that might increase your suffering?

3) What thoughts might be more helpful in promoting your long-term recovery?


Weekly Tip: When you experience negative self-talk, notice how this increases your suffering, and choose instead to fully accept yourself, including your imperfections.


For a free subscription to “Reflections”, please click here.

The OCD Center of Los Angeles is a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of OCD, Skin Picking Disorder, Trichotillomania, and related conditions. We offer the following services:

  • Individual Therapy
  • Low-Fee Group Therapy
  • Online Therapy
  • Phone Therapy
  • Home Visits
  • Intensive Outpatient Program
We treat adults, adolescents, and children, and offer services six days a week, including evenings and Saturdays. For more information, please contact one of our client coordinators at (310) 824-5200 (ext. 4), or click here to email us.

OCD Center of Los Angeles

(310) 824-5200

Written by
Kelley Franke, BA and Tom Corboy, MFT

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OCD Center of Los Angeles: 11620 Wilshire Blvd. #890, Los Angeles, California, 90025, United States

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Coconut Oil

Follow up:  Okay 5 days ago I wrote about how I was going to use coconut oil and castor oil to moisturize my hair and help it grow.  Well in my research I came upon this article and now I am thinking maybe coconut oil may not be so great, but I’m still going to give it a try.  It’s cheap and I already ordered it so why not.  I will let you know I how I fair with these products. I don’t expect a cure for anything, just some help with my dry, dull hair.  So I guess it’s all about expectations. I just hope it doesn’t give me a major allergic reaction that causes my head to itch like crazy. I will try not to put it right on my scalp…

In the mean time, some things to ponder:

1) Why there are so many people talking about it and its supposedly being so good… yet… it has not been firmly established as a one definite cure

2) If the Virgin Coconut Oil is so good as alleged to be,  then why there are still so many people still searching for (more) answers for their problem -after their first impression / belief that ‘it’ ‘finally’… ‘helps’?

3) How can anyone claim with certainty that taking it internally for x amount of time can have an effect – yet they are still looking for additional products and /or answers instead of ‘ It’ being declared as the SOLUTION we are so desperate for???



After using coconut oil for several months, I feel I can access my experience with it.  The coconut oil makes my hair feel soft and very moisturized for about a week after use.  I usually use it when I am having a rough time.  I load it in my dry hair, put my hair in a bun and leave it in for hours.  It’s so slippery that it make hard to pull.  I find it to be a great deterrent from pulling while it is on my head.  I have also learned that washing it out requires some very thorough washing.  The first time I used it, I just shampooed like normal and was left with greasy hair and scalp.  This of course irritated me and actually caused me to pull.  Now I know how to wash it out, so I do not have that problem.  I have not found that my hair grows any faster with the coconut oil.  I think it fits into a category of a very nice deep conditioner.  I have also found it to be a nice light moisturizer.  It is greasy when first applied, but it absorbs pretty quickly into my skin.

Regrowth Facts

MOST people DO have the capacity for hair regrowth. Most TTM people who do not think that their hair will regrow is because they HAVEN’T been in recovery LONG enough, so they think it won’t fill in, so they actually keep pulling. According to Dr. Novak, the LARGEST % of people HAVEN’T damaged their follicles enough to stop regrowth.

Peach fuzz or thinner than normal hair is a GREAT sign because it means your follicle IS still ALIVE! It does also mean it is temporarily traumatized, and that your hair is in a state of HEALING. Peach fuzz is a precursor to regular size hair, just as in babies.

Kinky hair also is a GREAT sign because it means your follicle IS still ALIVE! It does also mean a temporarily traumatized follicle, and that your hair is in a state of HEALING. The waiting game is LONG for these to go back to straight. One trichster said, “I have hair almost to my waist, and as I have changed my head criteria, I have foot long hairs that are at least 6 inches of kinky before they went back to straight.”

So, it is not an overnight process. Pulling out the kinky hairs is a mistake because you are actually making them more kinky each time, and traumatizing the follicle more each time – so it will take that much longer for it to go back to straight. It is possible, although NOT likely, that kinky hair might stay that way. In other words, for MOST people, once it is kinky, it WILL eventually go back to normal. (It is the eventually that we have a hard time with.) If your hair is growing in white, it will probably change back to its regular color after awhile. Means the color sac is (usually temporarily) traumatized, and will eventually start producing color  again. Age also was a factor in this. I have also had this experience. Some of my hairs go 1 inch and half Grey before changing back to dark brown. Again, a small % of people could permanently experience loss of
color – usually older people closer to the normal graying age.

Myths vs. Facts

Myth – There is a pervasive, erroneous worry out there that “root” pullers damage their hair more than the “other” pullers.

Myth – If/ when you pull and get the “white” thing, you won’t get their hair back, or higher probability that you won’t get your hair back..

FACT – If the hair comes out, the root IS out, and ALWAYS is out, no matter what is attached to it.

FACT – It DOESN’T matter anyway, because the old root DOES NOT generate the new hair.

FACT – The MAJORITY of us can have TOTAL regrowth!

FACT – VERY IMPORTANT – What you may or may not see attached to the root has NO affect on possibility for regrowth. It is NOT a sign of permanent damage! People see all kinds of weird things on the roots – and there are tons of things that go in that make the root look different at different times in the growth stages – size, shape, color, stuff attached to it, etc.

FACT – Pulling lots of the white things means you are pulling all the “Youngest” hairs. It may mean it takes longer for those hair follicles to gear up again since they normally wouldn’t regrow until that hair died and fell out naturally.

FACT – Pulling the kinky hairs will probably make them even more kinky – further SLOWING down the healing process for that follicle.

FACT – Pulling the extra thin (peach fuzz) hairs makes the healing process START over, you would have to get a new extra thin (peach fuzz) hair, before you could get a regular hair, so you are SLOWING down the
healing process.

FACT – You can see above how our own pulling patterns can make us think we are not getting our regular hair back, when in fact we ARE!


Different areas of hair have different chances for recovery speed.

Lashes – FULL recovery, some people can get them in 6 months, if you have been pulling for years and years – could be 2-4 years.

Eyebrows – FULL recovery, can be slower than Lashes – this is an area more easily damaged and does not regrow totally back for some people.

HEAD – FULL recovery, 2-6 years for Normal Hair! Think about it, your hair only grows 1/4- 1/2 inch a month, and you have to wait for each hair pulled to start its growing cycle again. Plus, if it is growing in kinky or “peach fuzz”, you have to wait a long time (my experience 6 months), for that phase to change back to regular hair. And then you have to grow length again. I think the Doc’s time frame also takes into account people who are in the process of recovery, and having occasional pulling relapses.

On possible damage forever – Even in this chance, it would be pretty rare for someone to be able to damage ever follicle on their entire head! There are usually physical signs on your skin (not the pulled out hair) if you have permanently damaged follicles. If you had scabs and scars, that could be a sign for those particular spots of possible permanent damage. You would STILL have to wait to recover from TTM behaviors, and stop picking at those areas for MONTHS before you would know for sure. Female pattern baldness areas are the easiest permanent damage area, and some people in recovery do have thinning and damage in those areas. But again, that is not the experience of MOST people! You can’t even begin to evaluate that until you have been pull free for months to years!


2a). The white thing is NOT the root, it is the Root Sheath (surrounds the root) – also sometimes called the bulb. The white thing is only present in Growth Stage 1 of hair (the youngest stage).

*The root sheath is what drives me wild.  I can’t stop until I find one with that thick clear coating around the root.  I can often feel them as those are the hairs the itch the most or are extra wiry.  Of course after I find one I just want more.  Its always just one more…but it’s never only one more.

2b). The part you pull out is the root. The root sometimes has the white root sheath around it, sometimes NOT. Sometime the root will have other things on it, including a black bulb.

2c). If you pull out your hair, you usually can see the root. It looks very different at different growth stages. It
is the rounder part at the bottom – but how round or oval it is varies depending on the growth stage. Sometimes it is so round it looks like an onion with a stalk, where the root is the onion. Sometimes it is so
straight, the root is just the 1mm at the bottom (it is big enough to see). If you see the white bulb, the root is under the bulb, more towards the bottom. Sometimes there are other types of cells attached to the root, which can be different colors, or different textures, some kind of see-through, some not. If you see an “ink spot” at the bottom, that is probably because you also have a root sheath or attached cells looking “white” or “lighter color” – and are seeing the “black ink spot” at the bottom which is just a spot of the root without the root sheath. i.e. like looking at the end of a hot dog (root) sticking out of the bun (root sheath).

2d). Normally, when hair falls out on its own, the root falls out, and the hair grows back completely. You can’t damage the root by pulling, because it is gone. The root has nothing to do with regrowth. “


One of the biggest concerns for trichsters is hair re-growth. It is also one of the most difficult questions to answer. Re-growth will largely depend on the duration and intensity of the pulling. There have been cases where people who have pulled for 30 years have achieved full coverage once they have become pull free, whilst other have permanent damage after 5 years of pulling.

First lets look at the structure of the hair. KERATIN, the same strong protein that makes fur and feathers in animals, and the outermost layer of skin and nails in humans, is the main protein composition of our hair.

Each strand of hair consists of three layers.

MEDULLA – is the innermost layer which is only present in larger, thicker hairs.

CORTEX – This is the middle layer and is responsible for the texture and color of hair.

CUTICLE – This is a thin, colorless protective layer. Below the surface of the skin is the hair root, which is enclosed within the hair follicle

At the base of the hair follicle is the DERMAL PAPILLA The dermal papilla is fed by the bloodstream, which carries nourishment to produce new hair. The dermal papilla is very important to hair growth because it contains receptors for ANDROGENS, which regulates hair growth. To understand how hair grows lets take a look at the normal hair growth cycle. Hair follicles follow a genetically programmed cycle that can be broken down into 3 stages.

ANAGEN – GROWTH PHASE About 85% of hair follicles are in the growth stage at any one time. This stage varies from 2-5 years with hair growing approx 10cm per year. Eyelash, arm and leg follicles have a shorter growth stage lasting only a few months so the resulting hairs are shorter.

CATAGEN – TRANSITIONAL PHASE This stage lasts about two weeks. During this stage the follicle shrinks to 1/6 its normal size. The lower part of the follicle is absorbed by the body and hair growth ceases.

TELOGEN – RESTING PHASE About 15% of hair follicles are in this stage at any one time. The resting phase normally lasts about 2 months. During this stage the bulb of the hair shaft moves closer to the surface of the skin. This causes the hair to loosen and then it is shed. At the end of the telogen phase the hair follicle re-enters the anagen phase. The follicle enlarges again and a new growth cycle starts.

Hair is continually shed and renewed by the alternating cycle of growth, rest, fallout, and renewed growth. Each follicle follows this cycle independently of others, so the total number of hairs normally remains consistent. On average 50 -100 hairs are shed per day. This does sound a lot but when you consider the total number of follicles on your scalp is around 150,000, it is a very small amount.

FOLLICLE DAMAGE When you pull a hair the hair follicle will try and repair any damage that has occurred. The human body has a remarkable way of repairing itself but this can take some time. If you pull a hair and the root is not pulled out this means that the hair is in its resting phase, however if you pull a hair with the root attached the hair is in the active phase which means it is actively growing. If you pull part of the root out this can damage the hair follicle.

The BLACK tip you see on some hairs is the area responsible for color pigment. While the hair follicle is repairing the hair will grow but the MELANIN (which gives hair its color) will not have ‘fused’ with the protein cells that are our hair, causing the hair to grow in grey or white. In time your normal hair color may re-establish itself, but this is not always the case. The follicle may be repaired enough to grow but the formation of melanin can cease which causes the hair to stay grey or while. Hair can also grow in different eg- if you have straight hair it may grow in curly.

If you pull the hair and the whole follicle comes out with a RED tip, you have just detached the blood supply and muscle. This is permanent damage. This means that the hair will NOT grow back.

RECOVERY TIME FRAME Different areas have different chances for recovery speed. This is just an estimate of how long FULL recovery will take. You will see new growth fairly quickly in most cases.

LASHES – Some people can get FULL recovery in 6 months but if you have been pulling for many, many years it could be 2-4 years.

EYEBROWS – FULL recovery can be slower than lashes because this area is more easily damaged and for some people it does not totally grow back.

SCALP – FULL recovery for normal hair can take 2-6 years. This sounds like a long time but you have to remember that your hair only grows about an inch a month.

You have to wait for each hair pulled to start its growth cycle again and if it is growing in “funny” you have to give you body time to repair itself, then you have to wait to grow length again.

Coconut Oil and Castor Oil for Hair Growth

I have read about the benefits of castor oil and coconut oil for hair regrowth.  This is an affordable hair treatment so I ordered some of each and will post my results.

castor oil $6.79

coconut oil $12.95

Here is a great tutorial about using these products:

Using Castor Oil and Coconut Oil to help your hair grow!


In my experience these products do not cause hair to grow faster or thicker.  I would recommend these products for hair conditioning, but that is the extent of their wonder.

Biotin for Hair Regrowth

I have started taking Biotin to help my hair grow back.  Biotin is a B vitamin found most commonly in prenatal vitamins. Biotin is supposed to encourage hair and nail growth. Right now I’m taking 10,000 mcg per day as that seems to be a helpful amount for me. Whether it really helps my hair grow better time will tell, that is if I can stop pulling long enough to let my hair grow back.

For those of you who are unaware, extremely high levels of biotin are the “miracle” workers that can be found in 99% of these hair growth medications that are being sold on the market today. Biotin is a water soluble B vitamin that produces keratin, increases hair elasticity, and protects the hair from becoming dry. It also helps thicken the hair to give the appearance of fullness. It is usually paired with MSM which my some hair, skin, & nails supplement do contain.

Will They Grow Back

One fear I have obsessed about is that my hair, lashes, and/or brows will not grow back.  In a quest to find answer, I fond the following information most helpful.

According to the book “The Hair-Pulling Problem A Complete Guide to Trichotillomania” by Fred Penzel. There is a huge section on hair growth charts and facts. If you haven’t picked up this book I highly recommend it for understanding more about trich.

According to the book, Eyebrows Average Daily Hair Growth Rate Female is 0.16 mm.

Average Daily Rate of Hair Growth by Age and Area- Young Adult Eyebrow 0.14 mm. Mature Adult 0.16 mm.

Time Required for Eyebrows Regrowth of pulled Hairs by Age and Area- Young Adult 65 (days). Mature Adult 56 (days).

Time Required for Regrowth of Pulled Hairs by Area and Sex-
Eyebrows Female 61 Days.

According to the book, although there is not a chart on eyelash growth, it should be noted that eyelashes are the slowest growing hairs on your body, with a daily growth rate of less than 0.16 mm. The follicles tend to go into a telogen, or resting phase following removal of hairs. Also note that these are merely average figures. The actual amount of time it takes for your hair to grow back may differ from the time spans, as hair growth can be affected by many different factors.

According to the book damage beyond re-growth could only occur if infection is in the follicle, this can lead to permanent scarring of follicles, preventing further hair growth. This is more likely to happen as the result of picking at the skin with implements such as needles or tweezers to get at hair roots or ingrown hairs. A hair shaft grows from the papilla, and as long as the papilla has not been seriously damaged or destroyed, hair will continue to grow.