Can OCD and Other Personality Disorders Lead to Hair Loss?
The first step in determining if OCD can lead to a person experiencing hair loss is to understand exactly what OCD is and the impact it can have on daily life.
OCD is short for Obsessive-Compulsive Disorder and it is an anxiety disorder known to cause fear, worry and unease due to intrusive thoughts. A person that is suffering from OCD performs repetitive behaviors in the hope of relieving the cause of the anxiety. The repetition of the actions happens regardless of the effect it has on their personal and/or professional lives.
Some common examples of OCD behavior include:
- Opening and closing a door a certain number of times each time a person enters or leaves a room
- Checking the locks on a door multiple times even though they have already been locked
- Only following certain paths while walking through a building or on a street.
A hair loss problem can come about due to the OCD behavior of a person suffering from the disorder. For example, patients can perform compulsive pulling of their hair on a daily basis. This action can lead to the hair being pulled out and this condition is known as trichotillomania. While the hair loss that results from pulling the hair can be treated with a hair transplant, the psychological condition must first be treated to ensure the hair pulling action will not continue after the hair transplant.
The OCD behavior of twirling the hair while thinking about something else, or while performing everyday tasks, can also lead to the hair being pulled out of the scalp.
Are There Other Forms of OCD?
Another form of OCD that is damaging to the hair is dermatillomania which is a condition that is also commonly known as skin-picking disorder. People who suffer from this disease commonly pick at the skin on their face, scalp, arms and neck. While picking at the hairs on the scalp doesn’t specifically target the hair follicles in that area, they can become permanently damaged thanks to the action of repetitive scalp picking. The constant picking can make the skin sensitive and also cause it to lose its ability to heal properly. The hair can sometimes be pulled out of the scalp by the act of scalp picking causing open sores on the scalp. Picking at the scabs caused by the sores can lead to further permanent damage.
The act of repeatedly picking at the scalp can cause a great amount of damage to the hair follicles. Since the damage to the follicles occurs below the skin, the damage is seen on the outside as thinning or patchy hair. The greater damage that occurs below the surface of the skin is not visible to the naked eye. People who suffer from this condition continue to perform the damaging behavior regardless of the issues it causes to the hair as well as the physical pain caused on a regular basis due to the act of picking at the hair and the skin on the scalp. The permanent damage caused to the hair, as well as to the follicles below the skin, can lead to baldness on the scalp.
Skin picking is part of a group of disorders that fall under the heading of Body-Focused Repetitive Behavior (BFRB). It can often be confused with the hair-pulling disorder described above that is known as trichotillomania. The main difference between the two is this:
- Hair pulling disorders are characterized by an urge to pull the hair out of the scalp
- Scalp picking is when a person wants to constantly pick at the skin on the scalp
It is also important to remember that skin picking might be caused by a dermatological disorder or an autoimmune condition, In other words, skin picking might not simply be the result of a psychological condition. A clear diagnosis is vital to determining a proper treatment plan of the condition.
A Difficult Situation Made Even Harder
The loss of the hair on the scalp is a difficult situation for any person regardless of their age or gender. The addition of a psychological condition tied to the hair loss increases the difficulty of the situation. The person suffering from the psychological condition might not even realize that the condition is present so he, or she, may not recognize the reason that the hair loss is occurring.
The first step in properly treating the condition that is causing the hair loss is determining if the psychological disorder is being caused by OCD, Body Dysmorphic Disorder (a mental health disorder where a person continually thinks about flaws that they perceive to be present in their appearance) or depression. A patient will need to consult with a psychologist before proceeding with any long-term treatment plan. The treatment of any underlying psychological condition is an important step in determining if a hair transplant is a viable option for a patient.
Folliculitis After Hair Transplant
Hello Dr. Mohebi.
I had a FUT hair transplant last month at your Los Angeles hair transplant office and I am looking forward to seeing the final results. However, I have noticed that I am starting to get some pimples appearing on my transplant area. I know that you mentioned their appearance was going to be a possibility for me. I just want to know if I should I be worried that these pimples will have any type of negative impact on my hair growth?
Also, is it safe for me to put minoxidil on the area where the pimples are appearing?
Thanks in advance for the answers. I look forward to seeing you, and your staff, again in the near future at my follow-up appointment.
A:
Thanks for the questions. It is always better to ask them instead of simply being worried about the progress of your hair transplant results.
First, do not worry about the appearance of these pimples on the transplanted area of your scalp. It is quite common to have a few pimples appear after the performance of a FUT (Follicular Unit Transplant) or a FUE (Follicular Unit Extraction) on the transplanted area. These pimple-like lesions are the result of a condition known as folliculitis and they happen due to the inflammation of hair follicles. Folliculitis usually occurs between the first few weeks after your transplant all the way through the six month anniversary of your hair restoration procedure.
One of the important things to know about the appearance of these pimples is that there should be no more than 3-5 of them appearing on the scalp at the same time. If you have more than that at one time, or if they start to be become painful while also causing significant skin redness, you need to have them seen and examined in our office as we have experience in treating this issue. Although they are self-limiting and do not negatively impact the growth of your hair grafts, we can easily drain them in our office if they start bothering you.
As to your question about the use of minoxidil…Folliculitis doesn’t normally need any type of antibiotic treatment. In fact, a simple drainage of the follicles usually treats the condition. The use of Rogaine (minoxidil) on the specific areas where you are experiencing Folliculitis is fine as long as it does not irritate the lesions. If it does cause any irritation in the areas with the pimples, discontinue its use until your folliculitis is properly treated.
Using Hair Relaxer after Hair Transplant
Q:
Hi Doc!
I have a question for you. In the past, I used chemical hair relaxers. Do you think they damaged my hair follicles? If not, am I able have a chemical relaxer in my hair 6 weeks post-surgery?
Thanx!
A:
Hair relaxers do not seem to be absorbed through the skin. The generative parts of hair follicles are residing a few millimeters below skin level and any product that does not get absorbed through skin, cannot reach the active parts of the follicles and cannot affect their growth. Most cosmetics and other products can be safely used a few weeks after a hair transplant procedure, when the active inflammatory phase is over.
Thanks,
Shaved Hair for Scalp Scar Camouflage
I met a patient who had a hair transplant several years ago. He was in my office to check out his options for revising his scalp scar, but I had a hard time finding the scar when I parted his hair on the back of his head. He explained that he had come up with a method to hide the scar on a day to day basis.
I thought his way of camouflaging the scar was genius. I thought I should share his novel method and the photos with our blog followers. I am sure there are many people who can take advantage of this smart solution before they opt to do a scar revision procedure.

As you can see in the image, he has used hair clippings from his shaver to cover the scar. He applies a thin layer of honey to make the scar surface sticky so that when he applies the beard clippings, they stick to the scar surface. This produces the appearance of hair on the scar, making the scar almost invisible.
This is similar to using microfibers such as Toppik and other similar brands but with use of your own hair.
Q&A: What do I need to do after an FUE transplant?
Q:
Hi, Dr. Mohebi!
I’m about to have an FUE transplant and I want to make sure I do everything right to maintain my results. Do I need to sleep differently, or buy special shampoos and brushes? Help!
A:
Thanks so much for your question! Because FUE transplants are so much less invasive than traditional FUT strip procedures, the aftercare is much simpler. Different clinics have different procedures, but the general principles tend to be the same.
The first day after a transplant, we bring the patients back in for an evaluation and hair wash. We teach them the proper technique for washing their hair the first few days after the procedure, and we give them special shampoo and a sponge for the first two weeks following the surgery.
Patients do need to sleep semi-upright after their treatment. This reduces swelling faster and prevents the patient from accidentally touching their new hair at night.
Patients should definitely avoid strenuous exercise for the first few days following surgery, but should be fine to work out within the week. The only activities patients should really try to avoid are contact sports and anything that involves touching or rubbing the transplanted area.
Dr. Parsa Mohebi is a nationally ranked hair transplant surgeon located in Los Angeles, CA, and he is available to answer your questions. Are you concerned about hair loss? Would you like to know more about the hair transplant process? Submit your question to info@parsamohebi.com and follow us on Twitter and Tumblr!
Q&A: Does Hair Continue to Thin After Hair Transplant?
Q:
Hi, Doctor!
One thing I’ve always wondered is this: If someone has thinning hair (around the temples, for example), and has a hair transplant done, essentially getting back the hairline they lost, I’d imagine it would look great and natural at first. But, would the hair loss continue from the previous point? Like, you’d have great hair for an inch and then suddenly thinning parts? If this is the case, then how do doctors and patients prepare for this inevitability? I don’t want to get a transplant if it just means that I’m going to be losing my hair or having my hair stopping and starting strangely after the transplant point!
A:
This is a very good question! The short answer is: yes, hair will continue to thin past the transplantation point.
Long answer: As this is something normal and natural, your hair transplant surgeon will do a microscopic evaluation before proceeding with the transplant. If there are signs that thinning will occur, the doctor will create what is called a “master plan” to proportionately transplant donor hair throughout the scalp. This may take multiple procedures to perform over varying lengths of time, but any good hair transplant doctor will be prepared for this possibility and will be able to help prevent it. Make sure to go to a good surgeon when you are ready for your transplant–any doctor worth his or her salt will know to prepare for future hair loss, and will be able to work with you to prevent it.
Dr. Parsa Mohebi is a nationally ranked hair transplant surgeon located in Los Angeles, CA, and he is available to answer your questions. Are you concerned about hair loss? Would you like to know more about the hair transplant process? Submit your question to info@parsamohebi.com and follow us on Twitter and Tumblr!
Two Months after Hair Transplant and No Hair Growth
Q:
Hello Doctor,
I hope you are well.
Just a few notes on my progress (which I don’t see at this point). Please keep in mind I know I should be patient up to 4-6 months. However, I do not see any of the implanted hair, especially on my temples and frontal area. Basically, all of the transplanted hairs have disappeared without any trace. Maybe this is good as I don’t seem to have redness, bumps or any indication of HT. Maybe my healing or your excellent job???
I have also suffered tremendous shock loss in the crown area and the frontal corners after the hair transplant procedure. Even though I am taking the prescription medicine as instructed my crown has never been so bare. Before, I was able to cover it up, now I have succumbed to using Toppik in order to cover this area until the new hair hopefully grows in and covers it up again.
I was just hoping for your thoughts, although I think I know what you are going to say.
A:
You guessed right and my answer is what you expect. All individuals react differently and approximately 10% of the individuals never completely lose hair after receiving a hair transplant. Most individuals lose every transplanted hair and don’t see any hair growth at all before 3 months.
As it comes to shock loss, some individuals will lose their native hair which is prone to baldness 2-6 months after receiving a hair transplant procedure. What you are experiencing in your crown area can be the beginning of shock loss. At this point, you are losing some of your pre-existing hair and your transplanted hair has not yet grown.
You should start seeing early hair growth when you come in for your 6 month follow up appointment, and remember full results will be seen somewhere between 10-12 months after your hair transplant procedure.
Success Story: Hair Transplantation into the Scar
This blog is about how we successfully treated a 40 year old female patient with near total hair loss resulting from the complications of a facial cosmetic surgery that lead to significant scarring and hair loss in the patient. This discussion will provide details about her evaluation, treatment, and long term results.
The story evolves below:
Immediately After a Complicated Facial Surgery
The patient visited our office for evaluation of the significant hair loss in frontal areas of scalp after a complicated facial plastic surgery. It was necessary to delay the procedure for 6 months after the initial consultation so that whatever hair that had not been damaged or may have gone through the Telogen Eflluvioum could grow back.
The First Hair Transplant Visit with Dr. Mohebi
After enough time had passed, we began our first experimental hair surgery using only a limited number of grafts.
Test Hair Transplant in Scar
The first transplantation, consisting of 786 grafts, was put into 8 boxes with approximately 100 grafts each. We then evaluated her results after 6 months, and found that there was nearly complete growth in the areas which we treated.
Hair Transplant for Full Coverage
We were encouraged by these results and decided to perform another hair transplant procedure that would target the front and corners of the patient’s head. We increased the number of grafts to 2,716 for the second procedure.
Final Result After Hair Transplant in Scalp Scar
Our patient experienced total hair growth 18 months after the last hair procedure. She was tremendously excited by the prospect of not having to cover her head. She was also able to style and fix her hair the way she had before her accident.
We are proud of the progress she made in her long recovery and hope her story will bring inspiration to others who have experienced something similar.