Trichorrhexis nodosa

• Causes, incidence, and risk factors

  Your genes may play a role in whether or not you develop trichorrhexis nodosa.

  Certain things you do to your hair -- such as blow-drying, over-brushing, perming, or excessive chemical use -- appear to trigger the condition.

  In some cases, trichorrhexis nodosa may be caused be an underlying disorder such as hypothyroidism, argininosuccinicaciduria, Menkes' kinky hair syndrome, Netherton syndrome, or trichothiodystrophy.

• Symptoms

  Your hair may appear patchy or like it's not growing.

  In African-Americans, looking at the scalp area using a microscope shows that the hair breaks off at the scalp area before it grows long.

  In Caucasians, the problem often appears at the end of a hair shaft in the form of split ends, thinning hair, and hair tips that look white.

• Signs and tests

  Examination of the hair shafts with a microscope may reveal changes that indicate trichorrhexis nodosa.

• Treatment

  Any underlying metabolic disorders should be treated appropriately.

  Improving environmental factors will reduce damage to the hair.

  Your doctor may recommend gentle brushing with a soft brush instead of aggressive brushing, ratting, or other procedures.

  Avoid harsh chemicals such as those used in straightening compounds and permanents. Do not use a very hot hairdryer for long periods of time. The hair should not be ironed. Avoid excessively harsh shampoos, but always use hair conditioners.

• Expectations (prognosis)

  Improving grooming techniques and avoiding products that damage hair will help correct the problem.

  This condition is not dangerous but may it affect a person's self esteem.

• Calling your health care provider

  Call your doctor if symptoms do not approve with changes in grooming and other home care measures.

• Prevention

  Avoid aggressive brushing and grooming, strong chemicals, permanents, straightening, and similar hair-damaging habits.

• References

  Diseases of the Skin Appendages. In: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2005: chap 33.

  Morelli JG. Disorders of the hair. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 661.

Review Date: 8/26/2009

Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network; Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.