Tonsillar trichophagia without trichotillomania: a pediatric case and psychiatric considerations

<p data-start="432" data-end="648"><strong data-start="432" data-end="447">Background:</strong><br data-start="447" data-end="450" />Trichophagia, the compulsive ingestion of hair, is most commonly linked to trichotillomania. However, isolated trichophagia without hair-pulling behavior is extremely rare, especially in children.</p> <p data-start="650" data-end="1183"><strong data-start="650" data-end="672">Case Presentation:</strong><br data-start="672" data-end="675" />We report a nine-year-old girl with isolated tonsillar trichophagia presenting with sore throat and dysphagia. Physical examination revealed dark hair strands embedded in the bilateral tonsillar crypts. Tonsillectomy confirmed localized hair bezoars. The patient’s mother had obsessive–compulsive disorder, and her father had generalized anxiety disorder, suggesting strong familial psychiatric vulnerability. The child underwent cognitive-behavioral therapy and family-based psychoeducation after surgery.</p> <p data-start="1185" data-end="1489"><strong data-start="1185" data-end="1200">Conclusion:</strong><br data-start="1200" data-end="1203" />This rare case demonstrates that trichophagia may occur independently of trichotillomania and can manifest in unusual locations such as the tonsils. Early psychiatric evaluation combined with surgical management is crucial to prevent recurrence and address underlying psychopathology.</p>