Hair Loss

Hair Shaft Abnormalities

Trichorrhexis Nodosa:

This condition is characterized by fragile and easily broken hair. It is very common and it presents as minute nodular concretions along the hair shaft.

Trichorrhexis Nodosa, can be seen at people with normal hair because of the aggressive combing style and communication with chemical applications. Trichorrhexis Nodosa may also be congenital, occurring in defective, abnormally fragile hairs following minor hair trauma. It is the most common congenital defect of the hair shaft. Argininosuccinic Aciduria, Citrullinemia, Menkes Syndrome can be the cause of Trichorrhexis Nodosa. Microscopic examination gives end-to-end “bristles tied together” image. Although there is no certain treatment, the treatment aims to minimize the damage of the hair shaft and includes avoiding chemicals and heating tools. A long time hair care is required to get full results.

Trichorrhexis Invaginata (Netherton Syndrome or Bamboo Hair):

Netherton Syndrome is a rare autosomal recessive genodermatoses, characterized by congenital ichthyosiform erythroderma, an atopic diathesis, and a characteristic hair shaft anomaly known as trichorrhexis invaginata.

This condition is also known as bamboo hair and is characterized by ball and socket abnormalities of the bristle shaft. In Netherton’s Syndrome, ichthyosis is a rare condition that occurs together with linearis circumflexa. It is also related with atopy. It usually occurs in infancy with short, sparse hairs on the scalp, but often affects the eyebrows as well. White, soft paraffin and 50:50 liquid paraffin were used as the topical treatment. Softeners, keratolytics and antibiotics are the mainstay of the treatment for the Netherton syndrome.


Monyletrix is ​​an autosomal dominant disease which is characterized by the beady appearance of the hair due to the periodic thinning of the shaft. It is known as necklace hair. It usually results in balding; there are few cases that resolve spontaneously.

There is no effective treatment available. Topical Minoxidil 2% (1 mL night and day for 1 year) caused an increase in normal hair shaft without any side effects in one report. Topical Minoxidil 2% can be an effective therapeutic option and also wigs can be used in advanced cases.

Pili Torti:

This is a rare disease which the hair shaft is bent and straightened on its own axis. Affected hairs are typically brittle and prone to breakage.

It can occur alone or in conjunction with Menkes Syndrome. (X-linked recessive multisystemic lethal copper metabolism disorder)

Spun Glass Hair:

This condition is also known as pili trianguli and canaliculi or fireproof hair. Patients have dry, wirey, silver-yellow hair that adheres directly to the scalp and looks like twisted glass. It occurs in childhood and usually resolves at a young age.

Loose Anagen Syndrome (LAS):

Loose Anagen syndrome was first described in 1984, it is a hair disease that is easily and painlessly pulled or shed from the scalp. There is widespread or uneven hair loss, and patients may feel constant shedding. Microscopic examination shows a ruffled proximal cuticle. There are no underlying associated abnormalities and children are generally healthy. Most cases resolve spontaneously in adulthood, in cases that do not improve, no problems are observed except for cosmetic problems, there is no treatment available.

Short Anagen Syndrome:

As the name suggests, the condition occurs with a shortened hair growth cycle such as the hair is not able to achieve their full length and requires trimming rarely. It is congenital, but there are reports of familial cases suggesting an autosomal dominant inheritance pattern. It is usually diagnosed in young children aged 2-4 years.

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