An unusual case of trichotillomania and trichophagia associated with authentic hair extension as seen in a young African-American female adult

Trichotillomania refers to repetitive pulling of hair from the body and may be accompanied by trichophagia, the ingesting of extracted hair. It is frequently comorbid with other psychiatric disorders and resulting hair loss can seriously affect quality of life. Trichophagia can lead to trichobezoars, indigestible aggregations of hair in the gastrointestinal tract that can cause pain and bowel obstruction. Descriptions of trichotillomania and trichophagia have generally assumed European hair texture and styling conventions with little attention to Black hair. Here we report the case of a 23-year-old African-American female patient that presented with a small bowel obstruction from ingestion of hair extracted from a hair weave, a popular styling practice and form of hair extension frequently used with women of African descent and various ethnic groups.