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This depends entirely on where you pull from, how severe it is, and what you personally think of it. For many people who suffer from trichotillomania, the biggest issue is the stigma and shame that comes with having bald spots, or no hair at all. For others, it's the pain that comes with repeated pulling of hairs, which often can bleed and scab. Many of us live with it by covering it up; using makeup to draw on eyebrows and mimick eyelashes, hair powders like toppik to cover bald spots, or wearing wigs. Although these are annoying to do every morning, being able to hide it helps us be confident in the way we present ourselves. But the biggest hurdle is learning to love yourself and being comfortable with it. Confidence and self-love work wonders.