Trichotillomania in Digital Support Communities: Emotional, Developmental, Treatment, and Social-Digital Patterns in a Spanish-Speaking Online Population

Trichotillomania is an underrecognized body-focused repetitive behavior that significantly affects quality of life, yet existing research often excludes Spanish-speaking populations and relies on small samples. To address this gap, an online cross-sectional survey was conducted with 198 Spanish-speaking participants recruited from digital support communities on Facebook and WhatsApp, exploring how social networks can facilitate inclusion and data access in mental-health research. This study addresses four central research questions: how emotional triggers relate to the frequency and persistence of hair-pulling episodes; how age of onset influences severity; how different treatments impact remission; and how participation in online support communities (Facebook and WhatsApp) influences perceived helpfulness and emotional support among individuals with trichotillomania. Most respondents reported onset between ages 6 and 15 (78%), with the 11–15 group showing the highest rates of chronic daily or multiple-daily pulling. Anxiety (25%) and stress (21%) were the most frequent triggers across all severity levels. Only 12.1% of participants were in remission, although combined therapy and medication yielded the highest remission proportion (28.6%). Participation in online communities was common (84.3%), and most users (60.6%) reported that these groups “helped a lot” or “helped sometimes.” Frequent engagement (daily or weekly) was strongly associated with higher perceived benefit, suggesting that sustained digital interaction enhances emotional support and knowledge exchange. These findings indicate that trichotillomania is shaped by interconnected emotional, developmental, therapeutic, and social-digital factors. Beyond clinical insights, this study illustrates the value of social-software platforms in reaching and empowering underrepresented mental-health communities through peer-based learning and emotional support.