Hair abnormalities are pathologies of the hair follicle and the shaft that disrupt the growth, structure and function of the hair cover. The main causes are considered to be infectious diseases suffered by the mother during pregnancy and genetic determinism. Anomalies are manifested by brittleness, twisting, thinning, loss, change in the condition of the hair. The research algorithm for hair anomalies includes spectral analysis and hair microscopy. Treatment consists in the regular use of individually selected hair care products.
ICD 10
L67.0 L67.8 L67.9
Meaning
Hair anomalies are quite rare, the most common of them are nodular trichoclasia (hair fragility) and trichoptilosis (split ends of hair). Trichoclasia and trichoptilosis account for no more than 4% of all hair pathologies, which are mostly acquired. Other varieties are represented by moniletrix (fusiform hair), bamboo hair (Netherton syndrome), trichotiodystrophy, Menkes syndrome, etc. Although hair anomalies are not dangerous to health, they represent a serious aesthetic problem and have an impact on the mental sphere of the patient, especially if we are talking about women.
Causes
The main cause of congenital hair abnormalities are adverse effects on the fetus during pregnancy. Among them are:
- Infectious diseases of a pregnant woman. Trichoclasia, trichoptilosis and other hair abnormalities may be associated with syphilis, tuberculosis, viral infections suffered by a woman in the first trimester of pregnancy.
- Toxic effects. The use of cytostatics, antibiotics and other drugs that affect the fetus during pregnancy can also lead to congenital pathology of the skin appendages. If, in addition to the altered follicles, there is a dystrophy of the sebaceous glands, then the disease is more pronounced and is accompanied by dryness and fragility of the hair.
- Other factors. Iron deficiency anemia during pregnancy, frequent stress, mental and physical fatigue adversely affect the fetus and can lead to various congenital anomalies, including more serious than trichoclasia and trichoptilosis.
With genetically determined trichoclasia and trichoptylosis, only a part of the hair follicles is affected, so the diseases are most noticeable in the first years of a child’s life. Over time, due to the increase in hair mass, the altered hair rods become less noticeable. The rest of the hair can be completely healthy if secondary dryness and brittleness do not join. Acquired cases of the disease are noted already in adulthood, more often due to the hard rubbing of ointments into the scalp, but after the withdrawal of drugs, the condition of the hair is normalized, such pathology is not genetically determined.
Symptoms of hair abnormalities
Trichoclasia
With ordinary trichoclasia, transverse fragility of the hair is noted, the formation of nodules on the hair shaft is possible. Nodular trichoclasia is characterized by the appearance of nodules on the hair shaft. Nodules appear on the lower third of the hair and look like dense translucent light or dark (depending on the color of the hair) thickening. The nodules are located on different hairs, in different quantities. At the same time, the rest of the hair is absolutely healthy. Multiple magnification of the hair affected by nodular trichoclasia allows you to see that the hair has longitudinal splits.
In the areas between the nodules, the hair is absolutely healthy, the absence of brain matter in the hair shaft is observed only in close proximity to the nodule. In areas affected by trichoclasia, the hair breaks easily and there are tassels at both ends of the broken hair due to stratification.
Trichonodosis
Trichonodosis or looping of the hair is externally manifested in the same way as nodular trichoclasia. And only when the affected hair is repeatedly enlarged, it becomes clear that these are not nodules, but loops. Dust particles, flaked epidermis and microorganisms accumulate in these nodules.
Trichoptilosis
With trichoptylosis, the ends of the hair split longitudinally, while part of the hair is affected, unlike split ends, when the bulk of the hair is affected. The tip of the hair splits into several parts and looks like a brush. Sometimes trichoptylosis is combined with dystrophic changes in hair follicles and atrophy of the sebaceous glands.
Moniletrix
One of the rare hair anomalies is moniletrix. This is a defect, and unlike other congenital malformations, moniletrix has no other pathogenetic causes. Moniletrix manifests itself at the 1.5-2nd month of life, at the same time follicular hyperkeratosis develops. Moniletrix affects the entire scalp or individual places.
There are a number of alternating thickenings and thinnings of the hair along the entire length of the hair shaft. On light hair, the areas thickened with moniletrix look darker, this is due to the presence of air bubbles in the places of thickening and its absence in the refined areas. Hair tends to break off in thin places, so the length of the hair cover rarely exceeds 1-1.5 cm.
Due to a congenital change in the innervation of the scalp, the hair follicles are subject to deformation, the hair becomes thinner, dry and brittle. There are deep changes in the hair follicle, starting from the bulb, which contributes to the development of chronic follicular hyperkeratosis.
Diagnostics
To differentiate moniletrix, trichoclasia, trichoptilosis and trichonodosis from acquired hair pathologies, modern trichology uses microscopy and spectral analysis of hair for the content of trace elements in them.
Treatment
The treatment consists in hair care. The use of specially selected medical cosmetics by a trichologist allows you to make these defects less noticeable, by increasing the elasticity and softness of the hair. In some cases, if the amount of affected hair is insignificant, but when combing due to nodules and thickenings, the hair gets tangled, you can resort to epilation of altered hair rods.
Forecast
Trichoclasia and trichoptilosis do not pose a threat to life, but, however, with significant lesions of the hair follicles or in combination with other hair pathologies, they can become a serious aesthetic problem in the future
Literature
- Pavone Р., Praticò A. D., Falsaperla R. et al. Congenital generalized hypertrichosis: the skin as a clue to complex malformation syndromes // Ital J Pediatr. — 2015. — Vol. 41. — P. 55.link
- Saleh D., Yarrarapu S. N., Cook C. Hypertrichosis // StatPearls Publishing. — 2022.link
- Ferriman D., Gallwey J. D. Clinical assessment of body hair growth in women // J Clin Endocrinol Metab. — 1961. — Vol. 21. — Р. 1440–1447. link
- Lorette G., Maruani A. Acquired hypertrichosis lanuginosa // N Engl J Med. — 2006. — № 25. — Р. 2696. link
- Yohannan M. D., Hilgeman J., Allsbrook K. Barber-say syndrome: a confirmed case of TWIST2 gene mutation // Clinical Case Reports. — 2017. — № 7. — Р. 1167–1169.ссылка