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Trichorrhexis nodosa

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

Causes

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 is caused be an underlying disorder such as hypothyroidism, argininosuccinicaciduria, Menkes' kinky hair syndrome, ectodermal dyspalsia, Netherton syndrome, or trichothiodystrophy.

Symptoms

Your hair may have patchy hair loss or it may appear like it is 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.

Exams and tests

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

Treatment

Any underlying metabolic disorders will be treated.

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.

Other things that may help improve the condition include: 
   •    Avoid harsh chemicals such as those used in straightening compounds and permanents. 
   •    Do not use a very hot hair dryer for long periods of time. Do not iron the hair.
   •    Do not use a harsh shampoo, and always use hair conditioner.

Outlook (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.

When to Contact a Medical Professional

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

James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 11th ed. Philadelphia, Pa: Elsevier Saunders; 2011: chap 33.

Sperling LC, Sinclair RD, El Shabrawi-Caelen L. Alopecias. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 69.

Updated: 5/15/2013

Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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