Eating hair disorder in children, known as trichophagia, often referred to as Rapunzel Syndrome, is closely linked to hair pulling syndrome or trichotillomania, which is more common.
Trichotillomania occurs when someone habitually pulls out their hair. The condition is usually disruptive to their ability to function normally on a daily basis. Adults with this disorder may be deterred by the hair loss being visible to others, whereas children, especially younger school age individuals seem to be less impacted by how they appear to people around them.
Trichophagia, is classified as a body-focused repetitive behavior (BFRB) that occurs when a person eats hair. There are many types of BFRB involving the compulsive consumption of non-food items, and these are categorized under the term Pica. Medical experts believe hair eating disorder is a rare condition believed to be caused by a chemical imbalance in the brain.
In some cases, a child will pull hair from their own head to consume, but some also eat hair from hairbrushes. Similar disorders to hair pulling and hair eating syndrome include nail biting and skin picking.
Tricophagia puts children at risk of developing a potentially fatal intestinal blockage. This makes it a more dangerous condition than trichotillomania, which is why it’s so important to seek medical attention if your child develops this disorder.
Symptoms
Symptoms of hair eating disorder include:
- Chewing on and eating hair
- Ingestion of hair
- Stomach pain
- Intestinal blockage
Although rarely, a side effect known as trichobezoar can occurs. Trichobezoar is the formation of a hairball in the stomach or intestines which is potentially fatal. Side effects include:
- Severe abdominal pain
- Nausea
- Vomiting
- Chest discomfort
- Change in the color of the stool
- Weight loss
- Constipation or diarrhea
- Loss of appetite
Left untreated, the trichobezoar grows into the colon and resembles a tail similar to the character Rapunzel, whose hair grew long while trapped in a castle for years. Induction of vomiting is most often the treatment for trichobezoar. However, in at least one case, surgery was needed to remove the hairball.
Behavioral medical experts believe that environmental, emotional, and/or cognitive factors all play a role in triggering the desire to pull and/or eat hair. Episodes can also be triggered by specific settings or activities. Additionally, certain emotions, such as anxiety, tension, and boredom might play a role. The behavior might also serve as a distraction for your child from negative and uncomfortable emotions.
Age of Children Affected by Eating Hair Disorder
Children typically develop trichophagia between the ages of 10 and 13.
Can Therapy Help?
Yes. Compulsive hair eating is a neurobiological disorder with a genetic component. Cognitive-behavioral therapy (CBT) is one of the most effective treatments for dealing with the disorder.
CBT helps children identify the triggers that cause them to pull out or eat their hair. Once they recognize their triggers, they develop alternative responses to the triggers. CBT is more than just changing a bad habit. It actually changes neural pathways and brain activity.
The goals of CBT treatment for hair pulling and hair eating include:
- Decreasing pulling episodes and urges to pull
- Developing effective management strategies for dealing with and stopping episodes once they begin
- Resuming daily routine and other levels of functioning
- Building coping skills for tolerating uncomfortable emotions and preventing pulling.
- Enlisting support from loved ones to help the child stop pulling
In addition to CBT, prescription antidepressant medications are sometimes used to control hair eating disorder.
Additionally, medication is used to treat problems that develop in the digestive tract as a result of trichophagia.
What Can Parents Do?
Parents should be aware of the warning signs of hair pulling and hair eating disorder. These warning signs include:
- Wearing hats, wigs and/o excessive eye makeup
- Excessive picking at hair
- Decline in academic or work performance
- Changes in social behavior
It’s common for anxiety and depression to also be a factor for those with trichotillomania and trichophagia. These conditions are used as coping mechanisms to self-soothe unpleasant feelings and difficult situations.
Suzanne Mouton-Odum, director of Psychology Houston and a clinical assistant professor at Baylor College of Medicine, has also run into the syndrome. Mouton-Odum explains, “Pulling hair is self-soothing. Most people never tell anyone. They think they’re the only person on Earth who does this.”
According to Mouton-Odum, parents shouldn’t panic or be frustrated. Instead, they should accept their child needs to soothe their nervous system and not worry that it’s a form of self-mutilating. Awareness training and CBT are helpful, but sometimes just explaining the risks of their actions to children is enough to help them stop.
In addition to having awareness of what’s going on with their children, parents can also do the following to deal with hair eating disorder:
- Openly communicate with your child about their feelings
- Provide your child with “fidget” alternatives to keep their hands occupied
- Plan de-stress sessions around times that might act as triggers, such as bedtime or times when children tend to get bored
- Encourage them to wear hand coverings, such as fun gloves
If you notice any of the symptoms associated with hair eating disorder or you suspect your child has developed the disorder, it’s important to seek medical attention to reduce the health risks associated with the ingestion of hair.
