Animals Affected

Cats

Overview

Psychogenic alopecia is a syndrome in which cats excessively groom their hair and skin. This results in hair loss and baldness that usually starts on the abdomen and progress up the rear of the body.

A synonym for psychogenic alopecia is psychological baldness.  As this name implies, the syndrome is believed to have a psychological or behavioral basis.

Psychogenic alopecia is frustrating to treat and usually is not curable.  However, the syndrome rarely poses a threat to the health of affected cats.

Symptoms

• Loss of hair resulting in baldness is the key sign of the syndrome.   Baldness usually is first noticed on the abdomen.  As the syndrome progresses, baldness may spread to the backs of the rear legs, the tail, and the skin along the spine.
• Affected cats may be noted to groom themselves excessively.  However, many cats engage in the behavior only in the owner’s absence.  These cats appear not to over-groom.
• Cats engaging in over-grooming may spit out hair in piles as they engage in the activity.  These piles of hair are sometimes found in the homes of cats with psychogenic alopecia.
• In most cases, the skin in the areas of baldness appears normal and healthy. However, in rare instances cats traumatize the skin in the process of over-grooming.  This leads to redness, rashes, or scabs on the skin.

Risk Factors

• As its name implies, the primary cause of the syndrome is a psychological tendency towards over-grooming.  The psychological basis for the syndrome is believed to be similar to obsessive-compulsive disorder in humans.
• In some cats, an extreme aversion to fleas may trigger over-grooming.
• Stress, anxiety, or boredom may trigger over-grooming and exacerbate psychogenic alopecia.
• Skin allergies to food, pollen, or environmental allergens may contribute to the syndrome.

Complications

For most cats diagnosed with the syndrome, psychogenic alopecia is a long-term problem.  The degree of baldness may wax and wane over time.

The most severe cases of psychogenic alopecia can result in near-total baldness on all areas of the body except the head.  Cats with severe baldness are at increased risk of sunburn and hypothermia.

As mentioned above, some cats traumatize their skin in the process of grooming.  This leads to rashes, irritation, and infection of the skin.

In most cases, psychogenic alopecia does not lead to major health consequences or decreased lifespan.

Diagnosis

Diagnosis of psychogenic alopecia is usually made after noting a characteristic pattern of baldness on an affected cat.  In some instances, skin tests, blood tests, and urine tests are performed to ensure other illnesses are not causing hair loss.

Treatment

Enrichment activities involving the owner may reduce grooming activities.  Owners may consider dedicating extra time to petting, playing with, and interacting with their cat. Games in which cats are encouraged to exercise (such as those that involve chasing toys or laser pointers) may be especially beneficial.

Cat toys exist that release food or treats as cats play.  Offering all or a portion of the cat’s daily food ration in this fashion may lead to reduced grooming.

Flea control should be considered in any cat that is diagnosed with psychogenic alopecia, regardless of whether fleas are noted on the pet or in the house.

Medications including prednisone, antidepressants such as amitripyline (Elavil®), and estrogen may help to alleviate the symptoms of psychogenic alopecia.  Medications are inconvenient and may lead to side effects.  Therefore, they generally are used only in severe cases.

In rare circumstances, Elizabethan collars (cone collars or “lampshade collars”) may be used to prevent over-grooming for brief, defined periods of time.

Feline facial pheromone (Feliway®) may have a calming effect on cats.  This may reduce over-grooming.

Follow-up

Psychogenic alopecia usually is a life-long problem.   The symptoms of the syndrome usually wax and wane over time.  However, most cats with the syndrome display a tendency towards over-grooming for their entire lives.

Miscellaneous

Psychogenic alopecia is sometimes compared to obsessive-compulsive disorder (OCD) in human beings.  Like OCD, psychogenic alopecia is not curable.  And, like most cases of OCD, psychogenic alopecia generally is not severely debilitating.

Copyright © Eric Barchas, DVM. All rights reserved.
The contents of this page are provided for general informational purposes only. Under no circumstances should this page be substituted for professional consultation with a veterinarian.