Trichorrhexis nodosa is a very common disorder that affects the hair shafts of the scalp hair. The hair shafts show presence of tiny nodules which are brittle regions on the shaft that cause easy breakage of the hair.
These whitish – yellow nodes are randomly distributed along the hair shaft they make the hair frail and prone to break easily. This defect can be hereditary and the condition manifests within the first year of the affected infants being born.
It is inherited in an autosomal dominant fashion. Different but most common cause is the acquired type, where a certain physical and chemical stress to the hair causes Trichorrhexis nodosa.
Some of the physical factors responsible for the damage to the hair shaft are excessive combing of hair, hair straightening and perming, blow-drying, use of high temperatures and long time exposure to ultraviolet radiation.
Also, chemical trauma like too much of salt water contact, excessive use of shampoo, bleaching and use of sprays on the hair make the hair shafts susceptible to developing this disorder.
Causes of Trichorrhexis Nodosa
The causes of trichorrhexis nodosa can be hereditary or acquired. Mutations in certain specific genes cause structural deformity in the hair shaft, rendering it weak and brittle. These regions of weakness further develop into the characteristic nodules which make the hair shaft prone to breaking easily.
The most common cause of this disorder is acquired, wherein external trauma and stress to the hair strands can make the hair liable to breakage. This physical stress includes excessive heat treatment, blow-drying or chemical treatment of hair.
Also, trichorrhexis nodosa can be triggered along with other conditions like iron deficiency, hypothyroidism, argininosuccinate aciduria (excessive build up of ammonia in the blood stream) and Menke’s kinky hair syndrome.
Diagnosis of Trichorrhexis Nodosa
The diagnosis of Trichorrhexis nodosa is done with the help of a microscopic examination. A hair strand is taken and investigated under a microscope for the characteristic whitish nodules.
Sometimes, a skin biopsy is done to check for genetic mutations. A recent diagnostic approach which is taken to investigate trichorrhexis nodosa has been trichoscopy.
Trichoscopy takes help of a videodermascope which then checks the hair as well as the scalp. The preliminary feature of two brushes pushed against each other in opposite direction can be observed by this method.
This is a non-invasive method and does not involve any plucking or cutting of hair strands. It is a very reliable and an easy method to diagnose trichorrhexis nodosa and other types of hair shaft defects.
Symptoms of Trichorrhexis Nodosa
The most specific symptom of trichorrhexis nodosa is brittle hair that breaks easily. Also, white flecks and nodules are observed on the hair shafts that vary in number.
Another symptom of this anomaly is dull hair and also the inability to grow hair long. Many a time split ends to the hair shaft are also observed.
Common Symptoms of Trichorrhexis Nodosa include
- Brittle hair that breaks easily
- Presence of white nodules on the hair
- Dullness in hair
- Reduction in hair growth
- Spilt ends on hair shaft
Treatment of Trichorrhexis Nodosa
The treatment of trichorrhexis nodosa depends upon its type. In acquired cases, reducing or altogether avoiding the physical trauma helps and brings improvement.
If there are any of the underlying diseases accompanying trichorrhexis nodosa, they are given the due course of treatment.
In order to prevent breakage, it is recommended to keep the hair hydrated and well conditioned. The affected individual is advised to follow gentle hair care and avoid harsh handling.
In the case of hereditary form of this disease there can be no such treatment given as there is a defect at the gene level. Sometimes however, there is improvement and reversal with age and hair shows normal growth.