Trichotillomania Part Three – Can People Have Hair Balls?

Cats are quite cute and cuddly creatures that completely ignore us and do their own thing until they need to be fed. However there is one thing they do that is usually quite load and not very pretty. They cough up hair balls. Now you might be asking yourself what on earth does that have to do with me. Well if you struggle with Trichotillomania (a hair pulling disorder) there might be a few health consequences you might not be aware of.

Some outcomes of trichotillomania can be distress, isolation, and secrecy. (1) If the scalp is the main plucking area, there could be a bizarre pattern of bald spots, reddening of the skin and skin damage. (2) Impairment at the work place or relationships can occur due to shame or embarrassment associated with this condition. Approximately 36% of individuals that have this condition have stated they have been less productive at home in the last year due to trichotillomania. (3) Preventing someone from enjoying an activity they would otherwise pursue like physical activities such as swimming are also recorded outcomes of trichotillomania. (3)

There is another very serious health consequence of trichotillomania. A rare form of the disease includes eating plucked hairs (trichophagy). Hair eating can cause gastrointestinal distress or a digestive blockage. Depending on the amount of hair eaten, hair balls can actually be created in the body, which is referred to as trichobezoar. There have been several cases where surgery has been required to safety remove these foreign bodies. (4–6) These hair balls can be found in the stomach or the intestine. (4) Some complications that have been associated with hair balls are the creation of holes in the stomach or small intestine, blockage occurring at the outlet of the stomach, and even death. (4) This is why it is imperative for those that have trichophagy to inform their doctor so precautions and medical corrections can be made.

Please stay tuned for the follow up blog on treatments for Trichotillomania and Trichotillomania in kids.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th Edition. Arlington, VA: American Psychiatric Publishing; 2013.
  2. Springer K, Brown M, Stulberg DL. Common hair loss disorders. Am Fam Physician. 2003 Jul 1;68(1):93–102.
  3. Diefenbach GJ, Tolin DF, Hannan S, Crocetto J, Worhunsky P. Trichotillomania: impact on psychosocial functioning and quality of life. Behav Res Ther. 2005 Jul;43(7):869–84.
  4. Ahmad Z, Sharma A, Ahmed M, Vatti V. Trichobezoar Causing Gastric Perforation: A Case Report. Iran J Med Sci. 2016 Jan;41(1):67–70.
  5. Jatal SN, Jamadar NP, Jadhav B, Siddiqui S, Ingle SB. Extremely unusual case of gastrointestinal trichobezoar. World J Clin Cases. 2015 May 16;3(5):466–9.
  6. Flaherty DC, Aguilar F, Pradhan B, Grewal H. Rapunzel syndrome due to ingested hair extensions: Surgical and psychiatric considerations. Int J Surg Case Rep. 2015;17:155–7.