Reason for tulip hair, exclamation point hair and some pili torti following a couple years of trichotillomania?

Over time, tulip hairs and exclamation hairs will disappear if an individual stops pulling. If you stop pulling out your hair, this problem can be corrected and normal growth can resume in most cases as long as the trichotillomania has not been chronically ongoing, thereby causing long-term damage that is difficult to repair. 

Trichotillomania (TTM) causes these hair shapes because of two reasons: the damage to the hair fiber and the damage to the skin below. Over time, tulip hairs and exclamation hairs will disappear if an individual stops pulling. However, pili torti may or may not stop as it is caused by scar tissue in the skin. This scar tissue is permanent and the hairs growing in that area are therefore permanently affected.

Exclamation point hairs are often a sign of alopecia areata and at times  trichotillomania . You can have both Alopecia Areata and trichotillomania