HealthlineWhy the ‘Rapunzel Syndrome’ Can Be Deadly

Rare psychiatric condition linked to hair-eating behavior poses serious health risks, highlighting the complex interplay between mental health and physical well-being

Rapunzel syndrome, a rare psychiatric condition characterized by the compulsive ingestion of one’s own hair, has gained attention following the tragic death of a 16-year-old girl in the United Kingdom in 2017. This disorder, closely related to trichotillomania (hair-pulling disorder), can lead to severe gastrointestinal complications and even fatality. The case reminds physicians of the critical need for early recognition and intervention in body-focused repetitive behaviors.

Key Points:

• Rapunzel syndrome is associated with trichophagia, the act of eating one’s own hair
• The condition primarily affects girls over the age of 12
• Approximately 10-20% of individuals with trichotillomania develop trichophagia
• Hair is not biodegradable, leading to the formation of hairballs in the digestive tract
• Complications include ulcers, intestinal obstruction, and potential organ failure
• The syndrome often goes undetected due to shame and lack of awareness
• Physical symptoms may include abdominal pain, nausea, and vomiting
• Hair loss or bald patches may be visible signs of the disorder
• The condition is classified as an obsessive-compulsive disorder in the DSM-5
• Effective treatments include behavioral interventions and habit-reversal training
• Awareness training and stimulus control are key components of treatment
• Competitive-response training can help patients develop alternative behaviors
• Early intervention is crucial to prevent severe medical complications

HCN Medical Memo
Physicians should maintain a high index of suspicion for Rapunzel syndrome in young female patients presenting with unexplained gastrointestinal symptoms or visible hair loss. Early diagnosis and a multidisciplinary approach involving psychiatric and gastroenterological care are essential for preventing potentially life-threatening complications.

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