All you need to know about Rapunzel Syndrome

The rare syndrome recently came into notice after an eight-year-old, Aditi in Bangalore was treated for trichobezoar, a condition caused by trichophagia, the compulsive eating of hair also known as Rapunzel Syndrome. Doctors operated on her and removed 5-inch hairball found in her gut. We speak to the experts about this lesser-known syndrome.
Seen in young females or adolescents suffering from psychiatric disorders, it is generally hard to detect the syndrome as a person can go many years without any symptoms. It is usually noticed when the hair ball becomes too large and compacted enough to bring about serious blockage in the stomach.
Some of the early signs of this issue include an intense urge to pull one’s hair. This urge can result from a stressful condition acting as a trigger. Although it can also occur without any trigger at times. The affected person can also show an abnormal behaviour such as patterns of hair pulling, biting, chewing and swallowing the pulled hair. Presence of bald patches on the scalp brought about by repetitive pulling of hair. Individuals suffering from the condition may feel a sense of embarrassment and even show feelings of shame, guilt and low self esteem.
Early signs and symptoms of the disease are continuous severe pain in the abdomen, vomiting, weight loss, anemia, and on inspection barred patches on the scalp due to hair pulling. Mental retardation can be present in most of the cases. It’s important to identify early symptoms of trichotillomania – the mental illness that often precedes the development of Rapunzel syndrome. It involves several symptoms, including repeatedly pulling out hair from the scalp, eyebrows, eyelashes, or other areas leading to obvious thinning or bald patches in affected areas which are easily differentiated from other forms of hair loss by a dermatologist. Usually a feeling of tension or anxiety before pulling hair and A sense of relief or gratification after pulling hair is a common symptom. Affected individuals engage in hair pulling in specific situations, like stress or boredom. Repeated unsuccessful efforts to reduce or control the behavior often characterises the condition. If identified in time , it can prevent the subsequent progression to ingestion of hair leading to hairballs and obstruction in the stomach.
In severe cases of infection, necrosis or perforation, surgery is carried to remove the ball of hair. However, patients need psychiatric follow up along with family members to keep the situation under control for remaining part of their lives.