Amelioration of Trichotillomania With OnabotulinumtoxinA for Chronic Migraine

A woman in her 30s with a history of trichotillomania (TTM) and chronic migraines showed significant improvement in TTM symptoms and hair regrowth after receiving off-label onabotulinumtoxinA (OBTA) treatment, initially intended for her migraines. Despite previous unsuccessful treatments with behavioral therapy and SSRIs, OBTA injections (45 units total) in the scalp led to marked improvement in TTM symptoms and hair regrowth as early as 12 weeks post-treatment, with sustained effects and further hair regrowth observed after one year and four treatment cycles.