Journal of Pediatric Health Care, 2026 (SCI-Expanded, SSCI, Scopus)
Background Trichotillomania (TTM) and trichophagia are rare in toddlers and usually involve self-directed hair pulling that leads to alopecia. Atypical patterns, such as pulling and ingesting others’ hair, may delay recognition. Trichophagia carries a risk of trichobezoar formation and serious gastrointestinal complications. Case Presentation A case is described involving a 23-month-old girl with a three-month history of persistently plucking and ingesting her mother’s and sister’s hair, including during their sleep. She also ingested loose hairs found on floors and furniture. Although predominantly other-directed, one isolated episode of self-pulling was reported. No alopecia was present, and physical examination, laboratory tests, and abdominal ultrasound were normal. Development was appropriate except for mild expressive language delay. Psychiatric evaluation confirmed TTM with trichophagia. Caregivers received psychoeducation and parent-mediated management strategies. Conclusions This case illustrates an unusually early, largely other-directed form of TTM with trichophagia. Early recognition and caregiver guidance are essential to prevent potential gastrointestinal complications.