This Self-Mutilating Behavior May Baffle, but It's Truly a Red Flag

Analysis by Dr. Karen Shaw Becker

Story at-a-glance -

  • Psychogenic alopecia, or excessive grooming in cats, occurs when normal grooming activity becomes obsessive
  • The disorder often begins as a displacement behavior or coping mechanism for kitties dealing with chronic stress
  • Symptoms of this condition include excessive licking, biting, chewing, hair loss, skin wounds and ulcerations
  • Before cats with excessive licking behavior are diagnosed with psychogenic alopecia, medical and environmental causes should be ruled out
  • Treatment for stress-related excessive licking is focused on stress reduction and environmental enrichment

Some cats take their natural tendency to groom themselves to the next level, turning it into a compulsion. Kitties who excessively lick and groom themselves have a condition known as psychogenic alopecia, which is one of the most common feline compulsive disorders.

A Common Trigger for This Strange Disorder

Excessive grooming often begins as what we call a displacement behavior. Cats do best with a daily routine that is predictable and consistent. As a response to a change or stressor in their environment, some kitties begin repetitively performing a specific behavior such as grooming to help reduce the emotional tension they’re feeling.

Licking releases soothing endorphins, so if the anxiety-producing situation is ongoing, the cat may practice the displacement behavior over and over until it becomes compulsive or habitual.

The type of stress that triggers excessive licking tends to be persistent and is often a combination of stressors that are cumulative. For example, a new family member, a move to a new house or even relocating the litterbox can upset the average kitty and trigger displacement behaviors.

Cats at Increased Risk

Female cats tend to be more prone to psychogenic alopecia than males. The disorder can happen at any age, but is commonly seen around the time of puberty. And there may be a genetic basis for this disorder, because it’s seen primarily in certain purebred cats, especially oriental breeds that tend to have anxious temperaments.

The disorder can also develop in kitties who are hospitalized, boarded or otherwise deprived of their freedom (i.e., kenneled for an extended period of time). Bored cats often exhibit the behavior, as well as kitties who are frequently stressed or have an anxious disposition.

Causes of Psychogenic Alopecia

It’s important to differentiate psychogenic alopecia from other reasons kitties lick specific areas of their bodies, such as pain or some type of skin condition. There are actually many medical reasons that cause cats to over-groom. If the problem is generalized itching, the licking will be widespread. If there’s a painful area, the licking will be focused on that spot. Where a cat focuses her licking can give clues as to the underlying issue, which can be any number of things, including:

  • Fleas or other parasites
  • Neurologic or chiropractic issues
  • Food or specific ingredient intolerances
  • A reaction to dust, pollen or mold
  • The presence of environmental toxins (e.g., VOCs, phthalates, scented candles or room sprays or plug-ins, household cleaning chemicals)

Conditions that aren’t skin-related but can cause excessive grooming include cystitis (inflammation of the bladder), hyperthyroidism and anal sac problems.

Identifying and correcting underlying environmental and medical issues is important before assuming your cat is licking for an emotional reason. If a kitty licks to the point of breaking the skin, infection can occur. The presence of infection will intensify the licking, which can result in an even more serious infection and a vicious cycle develops.

How to Distinguish Excessive Grooming From Normal Grooming

Cats spend about 30 to 40 percent of their day grooming themselves, and much of the remaining time is spent sleeping. That’s why it’s very common for pet parents to be oblivious to the problem until they notice significant hair loss, bald spots or scabs from over-grooming.

It’s also possible cat parents don’t notice the behavior because when they’re home with kitty, she feels more comfortable and relaxed and doesn’t need to self-soothe by licking. Obvious signs of psychogenic alopecia are excessive licking and chewing. More aggressive kitties can resort to biting themselves and pulling out clumps of hair. There may be shafts of hair that are chewed down to stubble; there also can be skin wounds or ulcerations.

In over-grooming situations, hair loss and skin damage will be localized to areas where your cat can reach to lick and chew. Often it’s the abdomen, flank, back, chest or the inner legs. There may also be a line of stubble down the back or on the front of the legs that looks a bit like a “buzz cut.”

In addition to excessive licking, there can be other signs of stress, including hiding, refusing to eat, nervousness or not using the litterbox consistently. However, I’ve seen lots of kitties with psychogenic alopecia whose only symptom of stress was compulsive grooming.

How to Help a Cat With Psychogenic Alopecia

When all medical issues have been ruled out or resolved and you’ve narrowed the problem down to an issue of compulsive behavioral licking, treatment should be focused on stress reduction and environmental enrichment. Cats like to eat at the same time every day, so make feeding time very consistent. Keep food bowls and litterboxes in the same location and, of course, very clean. Invest in an indoor hunting feeder for your cat.

Provide your kitty with lots of hiding boxes, access to high perches and appropriate scratching surfaces. Most cats enjoy interacting with their humans, so take time every day to be present with your kitty to ensure his emotional and social needs are being met. Also be sure to get your cat physically active every day with interactive toys like a laser pointer or wand toy. I think many cats today are bored to the point that it’s unhealthy, so it’s important to provide your kitty with options for mental stimulation throughout the day.

Catios (cat patios) and safe time spent outside can also be wonderful for indoor cats because it allows them to experience the natural world. Open the curtains or blinds before you leave for work so your kitty can see outside. Consider installing window perches and playing kitty videos while you’re away.

Brushing your cat’s coat is beneficial for removing loose hair and cutting down on hairballs, and many kitties really enjoy the attention. Talk to your integrative veterinarian about stress remedies for anxious cats. I’ve had great success using flower essences, homeopathics and acupuncture with stressed kitties. Also consider feline facial pheromone sprays such as Feliway. CBD oil can be very beneficial for stressed cats, as can catnip, silver vine and valerian root.

Most importantly, you need to be patient, and please don’t ever punish your cat for over-grooming, as it will only make the situation much worse. Excessive grooming problems take time to resolve, much like any other compulsive behavior. With consistent attention, affection, environmental enrichment and a dependable daily routine, most kitties are able to conquer psychogenic alopecia. They regrow their hair and their quality of life improves within a few months’ time.