Hair pulling

In addition, behavioral and pharmacological co-treatment can offer substantial clinical benefit for trichotillomania, in both hair pulling symptoms and ancillary measures of functioning (264) (Fig.13-3). 

Swedo SE, Leonard HL, Rapoport JL, et al. A double-blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling). N EnglJ Med 1989 321 497-501. 

George MS, Brewerton TD, Cochrane C. Trichotillomania (hair pulling) [Letter], NEnglJMed 1990 322 470-471. 

Christenson GA, Popkin MK, Mackenzie TB, et al. Lithium treatment of chronic hair pulling. J Clin Psychiatry 1991 52 116-120. 

Psychiatric A rare compulsive behaviour which is caused by levodopa treatment is trichotillomania, which is characterized by the compulsive urge to pull out one s own hair. Since patients often feel ashamed or actively attempt to disguise their symptoms, this hair-pulling disorder may appear in conjunction with trichophagia, which is characterized by eating hair, usually their own. Most often, hair is pulled out and then the ends of the root bulb are eaten, or occasionally the hair shaft itself. The hair can eventually collect in the gastrointestinal tract and can lead to a hair ball called trichobezoar. This situation may cause a problem in administer duodenal L-dopa-carbidopa gel [65 ]. 

Epilation is required for permanent hair removal. The most effective epilation process is electrolysis or a similar procedure. Epilation can also be achieved by pulling the fibers out of the skin. Eor this purpose, wax mixtures (rosia and beeswax) are blended with Hpids, for example, oleyl oleate, which melt at a suitable temperature (about 50—55°C). The mixture is appHed to the site (a cloth tape may be melted iato the mass) and after cooling is rapidly pulled off the skin. A similar process can be carried out with a tape impregnated with an aggressive adhesive. 

When his gaze returned to mine I held it, then reached up and pulled the pins from my hair. It fell heavily about me with a breath of chamomile and feverfew he caught at the locks with both hands and buried his face in them so that they overflowed between his fingers. Then he let it fall and put up a hand to stroke the strands away from my face, and kissed me, not greedily now, but as if in a trance. 

Carothers had a poem for every Tarkio occasion. As he pulled on his turtleneck, he quoted the poet Keats Ah, bitter the chill it was . . . and silent was the flock in woolly cold. When a hair fell out, he quoted Swinburne The leaves of life keep falling one by one. On double dates, Carothers, Machetanz, and their steady girlfriends took turns sticking a knife at random into a poetry book and reading the poems that they found. 

Casualties/personnel Do not attempt to brush the agent off the individual or their clothing as this can aerosolize the agent. Remove all clothing immediately. To avoid further exposure of the head, neck, and face to the agent, cut off potentially contaminated clothing that must be pulled over the head. Wash the skin surface and hair at least three times with copious amounts of soap and water. Do not delay decontamination to find warm or hot water if it is not readily available. Rinse with copious amounts of water. If there is a potential that the eyes have been exposed, irrigate with water or 0.9% saline solution for a minimum of 15 minutes. 

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