Management of <i>Trichotillomania</i> by a Meaningful Competing Response Combined to Various Pharmacological Interventions <i>(Al</i><i> </i><i>Ain&

This technique includes using a tight scarf on the head and a comb plus or minus different pharmacological interventions. The tight scarf serves as a barrier for the first attempt to pull hair. If hair pulling is repeated, then head combing would be the second mechanism followed by putting the head scarf again. The hair combing is the meaningful competing response when feeling an urge to pull out hair, replacing knee squeezing and other meaningless competing responses. The overall impression by the patients and their families was that, this technique helped reducing hair pulling out and improvement was in average of 50% as per patients’ self-rated improvement and families’ observations to areas of hair loss. The fifty percent improvement included reduction in hair pulling frequency, allowing hair regrowth and reduced areas of baldness. The idea of Al Ain technique (ABT) - Al Ain is a city in UAE - stems from tailoring the behavioral intervention plan around the individualized patient’s behaviors and daily habits also tailoring the behavioral plan around the patients’ whereabouts to suit different patients with different circumstances and preferences in a meaningful way. This technique requires to be repeated in different parts of the world to hopefully replicate the results by other colleagues to have better evidence based status above case series.