The Lucinda Ellery Trichotillomania Management Programme

The management of Trichotillomania has not been clearly defined and is an area of ongoing research. The programme we use at Lucinda Ellery has been developed from the realization that the Intralace System® could be used as an important part of behaviour modification to 'break the cycle' of pulling. The use of the Intralace System® has been integrated with psychological and pharmaceutical approaches to produce a management programme that continues to be developed and researched in an attempt to provide the best possible outcome for patients with Trichotillomania.

The techniques and support for the management of Trichotillomania were developed at Lucinda Ellery and are at present unique to Lucinda Ellery.
It is hoped that they will soon be formally recognized as important and necessary tools in the management of this condition.

The Intralace System®

The Intralace System® is attached over the area of the hair loss. It is useful as a barrier and as a reminder to find alternative activities. We attach the Intralace System® in rows front to back and side to side. We note the number of connections. Perimeter connections are called locks and the interior connections are termed tracks. The terminology helps us to have a clear understanding when we are communicating with you and helps us to record your progress accurately.

When the hair is too long or there is too much volume to continue to use the Intralace System® we may then use single strand Medi Connections; to act as reminders and this does give some protection to the hair strands. This gradually allows access to the scalp and enables hair growth to become uniform.

Many clients will successfully move to a stage where Medi Connections are no longer necessary as their own hair has fully regrown to a density and length that they are comfortable with, however these clients are encouraged to contact us for support as and when it is needed.  We appreciate that some clients can have relapses, and so it is important to maintain the management techniques that have enabled you to regrow your hair. 


Trichotillomania may be associated with anxiety or depression; some patients find medication helps. There are specific medications that have been found to be useful. We suggest you see your Doctor to discuss this.

Habit reversal techniques


It will have been suggested that you find something small that you are able to carry around with you to busy your fingers when you feel the urge to pull. Many patients have found making a beanie bag helpful but anything similar that distracts you and that you have to concentrate on would be fine e.g. crotchet, knitting, computer games, tapestry, jewelery etc.


Behavior Monitoring

We will ask you to notice when and in particular where you are when you pull and if possible move away from that particular environment when you feel the urge. This is important for self monitoring and is a positive action in place of a reaction to pull.



Abdominal Breathing

This is a well recognized technique that helps to relieve anxiety and tension. It requires practice. Try it first when you are not tense so that you learn what it should feel like. Place one hand flat on the middle of the tummy over the tummy button. Breathe in and concentrate on pushing the air into that part of your stomach to make your hand move outwards. Breathe in through your mouth for a count of four. Repeat until you feel back in control and less anxious.

Buddy System

You will be given the opportunity to have a ‘buddy’ where possible, who is either using our programme or previously used our services, who will be available to talk to you and offer support.

Peer Support

There are regular social meetings at the consultancy where there is an opportunity to share views and ideas.

Reading List

There is a reading list available on request that details books which some patients have found helpful.

Access to an Out of Hours Crisis Line - England, UK GMT time only

If you need urgent advice this line is available for you to leave a message and a senior member of the team will return your call within 24 hours.

Follow-up Appointments

As part of the programme, you will be offered follow-up appointments at regular intervals, to answer any concerns you may have about the management skills and your progress.


If you wish to speak to us about hair pulling please call 310-288-0788 or use our Trichotillomania Contact form

Main Trichotillomania page >>


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