Introduction:
Samuel Wilks originally described Trichorrhexis nodosa in 1852. This illness is common and more frequent among people of African descent due to their unique hairstyle procedures. Trichorrhexis nodosa is a hair shaft anomaly that frequently occurs. It is distinguished by the appearance of hair strand nodules that result in alopecia and hair breakdown. The two main categories for this condition are acquired forms and congenital forms. The hair on the scalp is primarily impacted, but it may additionally impact the eyelashes, eyebrows, and pubic hair. Under a microscope, Trichorrhexis nodosa appears as tiny fissures in the hair shaft from which several fibers protrude, mimicking a pair of brushes pressed against one another in a reverse fashion. Trichorrhexis nodosa is most commonly seen on traumatized scalp hair, but it can also affect hair on other parts of the body due to anatomical variation that causes the hair to become fragile.
What Is Trichorrhexis Nodosa?
Trichorrhexis nodosa is a common clinical condition affecting the hair shafts of the scalp. Tiny nodules can be observed in the hair shafts, which are brittle and lead to easy breakage. These nodules are whitish-yellow and distributed randomly along the hair shaft. The symptoms are observed during the first year of the affected infants.
The various physical factors causing the damage to the hair shaft are too much combing of hair, perming and hair straightening, usage of increased temperatures, blow-drying, and long-time exposure to ultraviolet radiation. Another cause is the acquired type, including physical and chemical stress on the hair. Apart from these, chemical factors can also play a role.
Chemical factors include excessive contact with salt water, excessive shampoo usage, sprays, and bleaching. These make the hair shafts more prone to developing this disorder. Also, reports suggest this condition can be associated with many other syndromes and conditions. Examples are Netherton’s syndrome, iron deficiency anemia, Menke’s kinky hair syndrome, ectodermal dysplasia (a developmental condition characterized by aberrant growth and development of skin, hair, and nails), and hyperthyroidism.
What Are the Alternative Names for Trichorrhexis Nodosa?
The other names for this condition include the following:
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Hair shaft fracture.
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Brittle hair.
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Fragile hair.
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Hair breakage.
How Is It Caused?
The causes can be either primary or acquired. The mutations in certain genes may lead to changes in the structure or coding of the genes, causing structural changes in the hair shaft. These weakened regions develop into characteristic nodules that break the hair shaft more easily.
The most commonly recorded cause of this condition is acquired. In this, external trauma and stress to the strands of the hair can increase the risk of hair breakage. The various physical stresses include increased heat treatment of the hair, blow-drying, or any chemical treatment.
Various other systemic conditions can cause this condition, which is iron deficiency, arginino succinate aciduria (a condition characterized by increased accumulation of ammonia in the bloodstream), hypothyroidism, biotin deficiency (a condition whereby the body cannot utilize biotin, an element necessary for hair development), trichothiodystrophy (an uncommon genetic disorder that affects neural processes, skin, and hair), and Menke’s kinky hair syndrome (a condition that affects the body's copper levels).
What Are the Symptoms of this Condition?
The most peculiar symptom of Trichorrhexis nodosa is brittle hair that tends to break easily. The patient may experience white flecks and nodules on the hair shafts that may differ in number. Also, there is dull hair, which shows retardation in growth and has a yellowish tint at the tips. Split-ends can be observed in most of the patients. Many a time, split ends to the hair shaft are also observed.
How Can It Be Diagnosed?
When individuals visit the physician, they will be asked questions regarding the signs and symptoms, hair care habits, medical history, and medications. Then, a physical examination is done, followed by a microscopic examination of the hair. A hair strand is taken and observed under a microscope for whitish nodules. The physician may sometimes ask them to undergo a skin biopsy to assess genetic mutations.
Recently, a new diagnostic approach has been used to investigate Trichorrhexis nodosa, called trichoscopy. This method includes the usage of a video dermascope which helps in examining the hair and the scalp. It can help witness the preliminary feature of two brushes pushed against each other in opposite directions. It is a non-invasive method; patients do not have to worry about plucking or cutting hair strands. Also, it is a very reliable method that is easy to perform, and the diagnosis of Trichorrhexis nodosa and other hair shaft defects can be confirmed.
How Can It Be Treated?
The management of Trichorrhexis nodosa is based on the type. Reduction or avoidance of physical trauma can help improve acquired cases. Management of the underlying condition is required in cases associated with various conditions. Keeping the hair hydrated and well-conditioned is advisable to prevent further breakage. Gentle hair care and avoiding harsh handling of the hair are advised to individuals who have been affected by this condition. In hereditary-type cases, there is no exact treatment. However, the patient may show improvement with age and experience normal hair growth. Individuals must avoid using too-hot hair dryers and irons and use gentle shampoo and conditioner.
How Is the Prognosis?
The prognosis is very good in individuals with acquired Trichorrhexis nodosa. If the trauma to the hair is minimized or avoided, this acquired type can be reversed. Trichorrhexis nodosa can be easily controlled based on the growth rate of the new hair from the follicle.
How Can It Be Prevented?
Trichorrhexis nodosa can be prevented by taking proper and gentle care of the hair. As most cases are acquired due to numerous external environmental factors, avoiding these causes can help restore the hair to normal. Also, proper hydration and conditioning can show excellent results. If the person has alopecia due to Trichorrhexis nodosa, the effective method is mild natural therapies. Also, the individual should use agents that protect the hair from heat when trying to straighten or blow dry.
Conclusion:
Trichorrhexis nodosa is a common hair-associated condition that leads to the weakening and breakage of hair. The prognosis is very good, especially in the acquired type. Individuals can consult a specialist online to learn more about this condition.
