Trichorrhexis nodosa
Hair shaft fracture; Brittle hair; Fragile hair; Hair breakageTrichorrhexis nodosa is a common hair problem in which thickened or weak points (nodes) along the hair shaft cause your hair to break off easily.
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Causes
Trichorrhexis nodosa can be an inherited condition.
The condition may be triggered by things such as blow-drying, ironing the hair, over-brushing, perming, or excessive chemical use.
In some cases, trichorrhexis nodosa is caused by an underlying disorder, including very rare ones, such as:
- Thyroid gland not making enough thyroid hormone (hypothyroidism)
- Buildup of ammonia in the body (argininosuccinic aciduria)
- Iron deficiency
- Menkes syndrome (Menkes kinky hair syndrome)
- Ectodermal dysplasia (a group of conditions in which there is abnormal development of the skin, hair, nails, teeth, or sweat glands
- Trichothiodystrophy (inherited disorder that causes brittle hair, skin problems, and intellectual disability)
- Biotin deficiency (inherited disorder in which the body is not able to use biotin, a substance needed for hair growth)
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Symptoms
Your hair may break easily 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 other people, 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.
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Exams and Tests
Your health care provider will examine your hair and scalp. Some of your hairs will be checked under a microscope or with a special magnifier usually used by skin specialists.
Blood tests may be ordered to check for anemia, thyroid disease, and other conditions.
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Treatment
If you have a disorder that is causing trichorrhexis nodosa, it will be treated if possible.
Your provider may recommend measures to reduce damage to your hair such as:
- Gentle brushing with a soft brush instead of aggressive brushing or ratting
- Avoiding harsh chemicals such as those used in straightening compounds and perms
- Not using a very hot hair dryer for long periods and not ironing the hair
- Using a gentle shampoo and a hair conditioner
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Outlook (Prognosis)
Improving grooming techniques and avoiding products that damage hair will help correct the problem.
This condition is not dangerous, but may affect a person's self-esteem.
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When to Contact a Medical Professional
Call your provider if symptoms do not improve with changes in grooming and other home-care measures.
References
James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Diseases of the skin appendages. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 33.
Restrepo R, Calonje E. Diseases of the hair. In: Calonje E, Brenn T, Lazar AJ, Billings SD, eds. McKee's Pathology of the Skin. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 22.