Trich and PMS, stress, allergies
Hallopals,
Here's a quick and dirty analysis of the data on the Quick and Dirty poll.
(This means I'm not being entirely rigorous, and some of the following
interpretation may be a bit overstated.)
BASIC STATISTICS: 77 responses, about 18% of the current mailing list.
Lash pulling 43%; worse under stress 36% (that is, 84% of the 43%)
Brow pulling 42%; worse under stress 36% (that is, 87% of the 42%)
Scalp pulling 82%; worse under stress 73% (that is, 89% of the 82%)
Other pulling 64%; worse under stress 42% (that is, 66% of the 64%)
This basically says that lash:brow:scalp:other is in a 2:2:4:3 ratio, with
scalp heavily preferred, and that for all practical purposes, "I pull worse
under stress" is equivalent to "I pull".
Lash PMS-sensitive: 12% (that is, 27% of all such pullers)
Brow PMS-sensitive: 7% (that is, 17% of all such pullers)
Scalp PMS-sensitive: 48% (that is, 59% of all such pullers)
Other PMS-sensitive: 18% (that is, 27% of all such pullers)
The number of responses from people identifiably male was neglible (about 5
of 77). Some people responded that they really hadn't kept close enough
track, so they answered with a no. But the above points out that scalp
pulling does seem to be different from the remaining kinds, since more than
half are aware of a PMS connection; more evidence on that later.
Lash food-sensitive: 11% (that is, 26% of all such pullers)
Brow food-sensitive: 7% (that is, 17% of all such pullers)
Scalp food-sensitive: 43% (that is, 52% of all such pullers)
Other food-sensitive: 13% (that is, 21% of all such pullers)
These values track closely the numbers for PMS. Again, some people said
they had not paid enough attention and aswered with a no. But although it
is not the case that everyone gave the same answers about PMS-sensitive as
they gave about food-sensitive, these numbers suggest that PMS and food
sensitivities are closely related. It is not clear why. What this can
mean, though, is that having PMS suggests that dietary measures are likely
to be more successful.
Started pulling when living with cat/dog 64%
Currently live with cat/dog 66%
At one time cat/dog acted trich-like 25%
As far as I can determine, these are all way above chance. (Look down your
block: do 2/3 of the families have dogs or cats?) Together with the
observation that one in four trichsters had a trichy dog or cat, which is
generally taken to be a fairly rare problem, this suggests that perhaps some
forms of TTM may be communicable one way or another.
MORE COMPLICATED STATISTICS using factor analysis:
The data shows the following six basic groupings, in decreasing order of
popularity of the group. Items in parens are weaker contributors to a group.
To simplify the chart, I have omitted "more under stress" category since *in
every case* the category "I pull X more under stress" was grouped with the
category "I pull X", and with almost identical factor scores.
1) Lash, (Lash more PMS), Brow
2) (no Lash), Scalp, Scalp more PMS, Scalp more food
3) Lash more PMS, Brow more PMS, Brow more food, (Scalp more PMS),
Other more PMS, Other more food
4) (no Scalp more PMS), Other, (Other more food) Starts with pet, Pet had TTM
5) (Lash), Lash more food, Brow more food, (Scalp more food), Other more food
6) (Scalp food), Current pet
Simplifing further, and making up names for these factors:
1) Facial pulling
2) Scalp pulling only versus Lash pulling only
3) PMS with Food
4) Other pulling with Early Trichy pet
5) Food alone with Food-sensitive Lash pulling
6) Current pet
Let's start with the easy ones first. The analysis shows that having a dog
or a cat now has no effect whatsoever on any form of pulling. But it also
shows that there is a strong relationship between "other" pulling and
either a) starting pulling when there was a dog or cat around, or b) having
had a dog or cat with TTM-like behavior or c) both. Quite possibly this
can be taken to indicate that "other" pulling is a different sort of
pulling from the Big Three (lash, brows, scalp), and is possibly associated
with something that people have in common, or get from, or give to, their
pets. Or, if ever there was an "overgrooming" component to TTM, it looks
like it is this "other" pulling component.
Next, the analysis suggests that people who notice or have PMS-related
pulling in one place also notice or have it in every other place they pull,
too. That is, PMS-sensitivity is pretty much independent of pulling
location, and perhaps is more "central": it makes everything worse,
regardless of what is pulled. Likewise, so is food-sensitivity. Further,
PMS and food are in fact cross-linked (except possibly when it comes to
lashes, which is the most mysterious of the kinds of pulling anyway). Some
of the smearing of PMS with food may be due to people not being aware of
the potential impacts of one or the other on TTM; this data is not as crisp
as whether or not one pulls more under stress. But this clustering
confirms the similarity of the raw percentages at the very beginning of
this report.
The remaining factors are a little more tricky. Scalp pulling is in its
own category, where it is in fact strongly linked to PMS and food. This is
not surprising. But what is surprising is that there appears to be a type
of lash pulling that only appears if one does *not* pull scalp: a pure form
of just lash pulling that somehow refuses to spread (it is mathematically
in the "opposite direction"). More common though is lash pulling linked
with brow pulling; in fact, it is rare to find anyone who just pulls brows
at all. This combination of lash and brow can be called facial pulling,
and it appears to be very popular.
The only really problematic left-over with these factors is that there may
even be a third form of lash pulling, one linked to food sensitivity. This
is not terribly strong, so I will ignore it, but it does help point out
that lash pulling appears to come in at least two different forms. These
forms might represent different phenomena, and if I were a betting man, I
would bet that the pure lash form was due to an external allergy (like to
house dust perhaps), and was more fitful and sudden than the combined
facial form.
In summary, this factor analysis says: If you pull in other places,
something about it may be involved with pets. If you notice PMS
dependencies or food dependencies, they probably affect everything you
pull, and they probably are just different outward signs of the same
central sensitivity. There may be four different kinds of TTM: other
pulling, scalp pulling, and two different kinds of lash pulling, but no
pure brow pulling at all.
John
I cross-checked some of the results of this poll with prior ones,
and here are
some additional relationships.
1) The percentage of people who report PMS-dependent pulling is nearly the
same as people previously reporting allergies. Together with other anecdotal
evidence, I take this to suggest that it may be that at least 60% of all
pullers are affected by a yeast-related allergy, and may benefit from a
dietary approach. All other things being equal, this means scalp pulling in
particular would be more likely to be amenable to dietary control measures.
2) It is likely that "facial" pulling (lash and brow together) is a variant of
scalp pulling. Based on other anecdotal evidence, it may eventually spread to
include scalp pulling as well, as this seems to be the general direction of
change. Again, my guess is that for many people this is yeast-related.
3) Lash only pulling, a fitful, infection-prone kind, may be due to an allergy
to something airborne or carried on the hands. This could be dust or (what is
essentially the same thing) animal dander, as that seems to be a strong prior
finding in a prior poll. Perhaps it is due to a bacteria carried by dust or
animal dander, or maybe even both: first an allergic reaction leading to
inflammation and infection. If this is the case, then the best advice would
be to wash the face frequently and wash the hands before touching the lashes,
preferably with an anti-bacterial soap.
4) "Other" pulling may be related to an allergy to skin mites or some other
comparatively large organism (that is, bigger than a bacterium or yeast).
This would then be transmissible to and from pets, possibly even including
birds. Other pulling does not seem to be as focused as the head-related
pulling, which is also the case with afflicted animals. It may be
controllable by diet also, in which case the mechanism may be indirect: an
anti-yeast diet would help kill off some of the littler bugs (yeasts) that
these little bugs (mites) bite. About three TTM-like dogs have been reported
to me as having remissions based on the same dietary restrictions that have
been helpful for people.
5) Putting this together, what this suggests is that if you don't know what to
do to help your pulling, you might try keeping your face and hands clean with
an antibacterial soap, and being careful of Malassezia-friendly foods. None
of these can hurt, but they might help. My quick check of all my email
indicates that to date, about 25 pullers have gotten from weeks to years of
relief, ranging from "good" to "total", of their pulling and their
urges to
pull, from dietary control. This includes at least one child, and several
very long term pullers--some of them the result of Sara's "Diet Challenge".
The number is a bit higher if you include some skin-pickers who have gotten
relief, too.
That's it for now. Please send me, publicly or privately, your comments,
and the reports of your experimentation.
John
Raw numeric data for the above questionnaire
Here are the raw returns. Legend: 1 = yes, 0 = no, * = missing or
ambiguous
or doesn't apply..
John
- - - - -
1) Eyelashes: I pull them.
2) Eyelashes: I pull them more during PMS.
3) Eyelashes: I pull them more after eating certain foods.
4) Eyelashes: I pull them more when I am stressed.
5) Eyebrows: I pull them.
6) Eyebrows: I pull them more during PMS.
7) Eyebrows: I pull them more after eating certain foods.
8) Eyebrows: I pull them more when I am stressed.
9) Scalp hairs: I pull them.
10) Scalp hairs: I pull them more during PMS.
11) Scalp hairs: I pull them more after eating certain foods.
12) Scalp hairs: I pull them more when I am stressed.
13) Other hairs: I pull them.
14) Other hairs: I pull them more during PMS.
15) Other hairs: I pull them more after eating certain foods.
16) Other hairs: I pull them more when I am stressed.
17) About the time I started pulling, I lived with a dog(s) and/or a cat(s).
18) I currently live with a dog(s) and/or a cat(s).
19) One of the dogs or cats I have lived with has or had something like TTM.
- - - - -
1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
2 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 1
3 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1
4 1 * 0 1 0 0 0 0 1 * 1 * 0 0 0 0 0 0 *
5 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 0
6 * * * * * * * * * * * * * * * * * * 1
7 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 1 0
8 0 0 0 0 0 0 0 0 1 * * 1 0 0 0 0 1 1 0
9 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 1 1 0
10 0 0 0 0 0 0 0 0 1 1 * 1 0 0 0 0 1 1 0
11 1 0 0 1 1 0 0 1 1 1 0 1 1 0 0 0 1 0 0
12 * * * * * * * * 1 1 * 0 1 0 * * 0 1 *
13 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 1 1 0
14 1 0 0 1 1 0 0 1 1 0 1 1 1 0 0 0 1 1 1
15 1 * 1 1 1 * 1 1 1 * 1 1 1 * 1 1 * 0 1
16 1 0 * 0 0 0 0 0 1 0 1 0 1 0 0 0 0 1 1
17 0 0 0 0 0 0 0 0 1 0 * 0 1 0 * 0 0 1 0
18 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 1 1 1
19 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 1 1 0
20 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 0 * *
21 0 0 0 0 1 * * 1 1 * * 1 1 0 * 1 1 1 0
22 0 0 0 0 1 0 0 1 1 0 0 1 1 0 0 1 1 0 1
23 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0
24 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1
25 0 0 0 0 0 0 0 0 1 1 1 1 1 * * * 0 0 0
26 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0
27 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 1 1
28 1 0 0 1 1 0 0 1 1 0 0 1 1 0 0 0 1 0 0
29 0 0 0 0 0 0 0 0 1 * 1 1 1 * * * 1 1 0
30 1 0 0 1 1 0 0 1 1 0 1 1 1 0 0 1 1 0 0
31 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 * *
32 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 1 0
33 1 * 0 1 1 * 0 1 1 * 0 1 1 * 0 1 1 1 1
34 0 0 0 0 0 0 0 0 1 0 0 0 1 * * * 0 0 0
35 1 0 0 0 1 0 0 0 1 1 1 1 1 0 0 1 1 1 0
36 1 0 0 1 1 0 0 1 0 0 0 0 1 0 0 1 1 1 0
37 1 * 0 0 1 * 1 1 0 0 0 0 1 * 1 1 1 1 0
38 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 1 1
39 1 0 1 1 1 0 0 0 1 0 1 1 1 0 1 1 1 0 0
40 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0
41 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0
42 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0 1
43 0 0 0 0 0 0 0 0 1 1 * 1 1 1 * 1 1 1 1
44 1 * * 1 1 * * 1 0 0 0 0 1 * * 1 0 0 0
45 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 1 0
46 1 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0
47 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
48 0 0 0 0 1 0 0 1 1 1 1 1 1 0 0 1 1 1 0
49 * * * * * * * * 1 1 1 1 1 0 0 0 1 * 0
50 1 0 1 1 1 0 1 1 0 0 0 0 1 0 0 0 1 0 0
51 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 1 0 0
52 0 0 0 0 0 0 0 0 1 * 1 1 1 * 0 0 0 1 0
53 1 0 0 1 1 0 0 1 0 0 0 0 1 0 0 1 1 1 1
54 0 0 0 0 0 0 0 0 1 1 0 * 0 0 0 0 1 1 0
55 1 1 1 1 1 1 * 1 1 * 1 1 1 1 1 1 0 0 0
56 0 0 0 0 1 0 0 0 1 1 1 1 1 0 0 0 1 1 0
57 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 1 0
58 0 0 0 0 0 0 0 0 1 0 1 1 1 0 * * 1 1 0
59 1 1 0 1 1 0 0 1 0 0 0 0 1 1 0 0 1 1 0
60 1 1 1 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0
61 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 1 0 0
62 1 0 0 1 1 0 0 1 1 0 0 1 1 0 0 1 0 1 0
63 1 0 1 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 0
64 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 1 1 0
65 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1
66 0 0 0 0 0 0 0 0 1 0 * 1 1 0 0 1 0 1 0
67 1 0 0 1 1 0 0 1 0 0 0 0 1 0 0 0 0 1 0
68 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
69 0 0 0 0 0 0 0 0 1 1 * 1 0 0 0 0 0 1 0
70 0 0 0 0 1 0 0 1 1 0 0 1 1 0 0 1 1 0 0
71 1 0 0 1 1 0 0 1 1 0 0 1 1 0 0 1 1 0 1
72 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 1 1 1
73 1 1 0 1 1 1 0 1 1 1 0 1 1 1 0 1 1 0 0
74 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0
75 1 1 0 1 1 0 0 0 1 1 0 1 1 1 0 1 1 1 *
76 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0
77 0 0 0 0 0 0 0 0 1 * 1 1 0 0 0 0 1 0 0