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Trichorrhexis nodosa

Definition

Trichorrhexis nodosa is a problem in which thickened or weak points (nodes) along the hair shaft cause your hair to break off easily.

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, ectodermal dyspalsia, 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. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2011: 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: 5/13/2011
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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