Pulling out your eyelashes can be a symptom of various conditions, including anxiety, obsessive-compulsive disorder (OCD), or trichotillomania. You may find the urge to pull out your hair overwhelming, and once the hair is pulled out, you feel relief. In this sense, it’s a compulsion.
Your eyelashes help keep dirt and dust out of your eyes, so not having eyelashes makes the eye vulnerable to possible complications. Pulling out the eyelashes can also lead to irritation and infection, so getting help is important.
This article will review the symptom of pulling out eyelashes and the causes and treatment options.
Characteristics of Pulling Out Eyelashes
Your eyelash-pulling behavior may become noticeable by others when you lack lashes. A healthcare provider may also make this observation during an exam.
You may have an uncontrollable urge to pull out your eyelashes or do it without thinking about it. You may feel a sense of relief after pulling the eyelashes out. Or, you may have increased tension when trying to avoid pulling out the hair.
The hair-pulling may be ritualistic behavior, for instance, you pull it out in a specific way or search for a certain kind of hair. Attempts to hide the lack of eyelashes might also be made, like wearing false eyelashes.
Causes of Pulling Out Eyelashes
Trichotillomania is a common cause of pulling out eyelashes. This is a body-focused repetitive behavior in which a person pulls out their hair. It is an impulse control disorder and is sometimes classified as a type of obsessive-compulsive disorder (OCD).
If a person denies intentionally pullout out their eyelashes but they have no lashes left, they may have a disorder that causes hair to fall out. This includes alopecia areata (an immune system disorder leading to hair loss), as well as other forms of alopecia (hair loss). Alopecia does not involve pulling the eyelashes out on purpose.
Pulling out hair or eyelashes can also be brought on by severe stress or anxiety. A person may not have the coping mechanisms to handle these feelings, so they may turn to hair-pulling.
How to Treat Pulling Out Eyelashes
To treat someone who pulls out their eyelashes, an evaluation would need to be made by a mental health provider or other healthcare provider familiar with the condition. This evaluation will determine the correct underlying cause.
Having trichotillomania is often the reason for pulling out hair, but screening for other conditions is important to determine treatment. If trichotillomania is the cause, behavioral therapy is often effective.
Behavioral therapy involves becoming aware of triggers that set off the behavior and then changing the behavior. Habit-reversal training is particularly effective for pulling out hair. Interpersonal therapy to work on self-esteem and daily functioning might also help.
Medications such as selective serotonin reuptake inhibitors (SSRIs) can be beneficial. If medication is decided upon, it should be supervised by a psychiatrist with expertise in OCD and related disorders.
SSRIs can take up to six weeks at a therapeutic dose to become effective. If the medication does not help at all, it should be discontinued.
SSRI medications used can include:
Other medications that might be used include:
Complications Associated With Pulling Out Eyelashes
Eyelashes protect the eyes from dust, dirt, and sun. Without that natural protection, the eyes are more vulnerable to elements or debris.
Complications of pulling out one’s eyelashes can include:
- Skin infections or irritation where the hair is pulled out
- Eye problems due to the lack of protection from dust, sun, or debris
Are There Tests to Diagnose Pulling Out Eyelashes?
Pulling out eyelashes is not a condition in and of itself. It is a symptom of something else. A mental health provider will do a clinical interview with the person, take a medical and family history, and perform a physical examination. Other diagnoses will be ruled out, and an appropriate diagnosis can be made.
When to See a Healthcare Provider
Talk with a healthcare provider if you are pulling out your eyelashes or any other hair. They can refer you to a mental health provider who specializes in OCD spectrum disorders or anxiety disorders. Without treatment, the behavior is likely to continue.
Pulling out eyelashes can signal an underlying anxiety or obsessive-compulsive disorder. It can cause eye problems or complications. Pulling out eyelashes can be a symptom of trichotillomania but can also be brought on by stress.
Without treatment, the behavior will likely continue. It is treatable with behavioral therapies. Sometimes, medication also is prescribed.
A Word From Verywell
If you (or your child) has been pulling out eyelashes, know that you don’t have to deal with this alone. The condition causing hair-pulling is treatable, and you can learn to manage it.
Eyelashes help protect the eyes from dust, debris, and the sun. Talk with your provider or an eye care specialist about ways you can protect your eyes if you are pulling out your eyelashes. They may offer helpful advice while your eyelashes grow back.