PT  - JOURNAL ARTICLE
AU  - Engel, Emily Rubenstein
AU  - Ham, Jeremy-Ann
TI  - Amelioration of trichotillomania with onabotulinumtoxinA for chronic migraine
AID  - 10.1136/bcr-2022-254006
DP  - 2023 Feb 01
TA  - BMJ Case Reports
PG  - e254006
VI  - 16
IP  - 2
4099  - http://casereports.bmj.com/content/16/2/e254006.short
4100  - http://casereports.bmj.com/content/16/2/e254006.full
SO  - BMJ Case Reports2023 Feb 01; 16
AB  - We report a case of a woman in her 30s who struggled with a life-long history of trichotillomania (TTM; hair-pulling disorder), which was unsuccessfully treated with behavioural therapy and selective serotonin reuptake inhibitors. In addition to TTM, our patient had a history of chronic migraine which brought her to our clinic, and treatment with onabotulinumtoxinA (OBTA) was initiated per the Phase III REsearch Evaluating Migraine Prophylaxis Therapy protocol. After experiencing improvement with migraine symptoms, she began off-label treatment with OBTA for her TTM with 45 units being injected, 5 units per site, in diffuse regions of her scalp, primarily on the affected areas of TTM-induced alopecia. The patient reported marked improvement in her TTM signs and symptoms, which resulted in hair regrowth as early as the first follow-up visit 12 weeks post-treatment initiation. Treatment effects were maintained, and additional hair regrowth was observed at the 1-year post-treatment visit, which equated to four cycles of treatment.