DUBAI // When AS stood in front of her university class to tell them about her condition, she did not expect anyone to take her seriously.
The 22-year-old Emirati has been pulling her hair out since she was 12. By the time she turned 17 she had developed bald spots.
"My announcement was a shock for the whole class - especially for my lecturer, because no one thought the girl in my story was actually me," she said. "But I have come across many girls who disclosed their [hair] pulling to me and I am certain there are many others who are going through this and are looking for help and support."
What AS's condition is called trichotillomania (TTM). Doctors are not sure what causes the impulse control disorder, but believe it may be linked to stress or depression.
"I used to pull my hair a lot in high school," said the Abu Dhabi-based student. "I am not sure why, but it could have been due to pressure.
"Many people do not even know TTM exists. When I disclosed my [hair] pulling to my family, they did not take me seriously at first. It was only when I showed them my bald areas that they took action."
Sue Partridge, a clinical psychologist at the American Center for Psychiatry and Neurology in Abu Dhabi, said TMM starts as an innocent habit.
"Lots of little girls fiddle with their hair," said Dr Partridge. "Some then learn that to do so distracts them from negative emotions and relieves tension or in some other way has a benefit to them so they do it more frequently."
Dr Partridge said there were no figures available on the prevalence of the condition in the UAE.
"There aren't any statistics because, firstly, we don't have a national patient database that collects information on people presenting for treatment for mental health problems in health facilities," she said.
"Secondly, mental health epidemiology is in its infancy here so research can't fill the gaps left by inadequate patient administration systems."
When AS got up to tell her university class about TTM, she expected ridicule. Instead, she was approached by classmates who believed that they too had the condition and wanted to find out more.
"People here need to be educated about this topic so that they know how to deal with their daughters who have trich," she said.
KA, a 21-year-old Emirati, picked up the habit during her second year of university.
"I find myself pulling my hair whenever I study. I am always stressed and frustrated and I don't know what subjects I should take in my major," she said.
Pulling her hair is about releasing some of her stress, she said, but the condition has left her with bald spots.
"It used to be really severe until last year, but I realised that the hairless spots were getting bigger and more visible. So now I try to stop every time I realise that I am pulling my hair," she said.
Apart from the physical side effects, the condition also affects women psychologically.
"Mentally, I am devastated because it makes me feel less pretty than the 'normal' girls," said KA.
"The guys look for the pretty girls, therefore, my biggest fear is that if a guy noticed that then he might feel disgusted, or might mock me about it, or compare me with others, which will hurt my feelings," she said.
KA's family are aware of her behaviour, but she said they do not pay any attention to it and believe it will go away with time.
Like many others with TTM, FA was hesitant to break the news of her condition to her family.
She developed TTM 12 years ago and still pulls her hair when she is stressed or while focusing.
"I cannot tell you why I do it, I really don't know," said the 22-year-old Emirati student. "I don't feel myself doing it at times.
"Telling people that you impulsively pull your own hair out, that you don't feel yourself doing it, and have no control over it … it is hard to understand."