The current DSM-V criteria necessary for a diagnosis of TTM.
Criteria A: The person must be removing hair from a body region. The hairs can be from a concentrated region or a diffuse area. There may be associated bald spots or thinning of the hair.
Criteria B: the person must have tried to stop or decrease hair removal.
Criteria C: The removal must cause significant distress or impairment in at least one area of functioning.
Criteria D: The hair pulling or loss cannot be caused by another medical condition (e.g., alopecia areata, tinea capitis).
Criteria E: The hair pulling is not better explained by some other mental disorder and its symptoms.
American Psychiatric Association. Washington DC: American Psychiatric Association; 2013. Diagnostic and Statistical Manual of Mental Disorders (5th Edition), Text Revision.