Disorders characterized by self-destructive actions toward hair and skin are primary mental disorders that are typically diagnosed by a dermatologist and represent a rather diverse group of conditions. Trichotillomania is the most common pathological destruction of hair caused by self-induced pulling. Given the disease’s psychotrichological profile, managing patients with pathological hair and scalp destruction necessitates considerable effort, experience, and knowledge, as well as patience and a multidisciplinary diagnostic approach.