Trichorrhexis nodosa

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

  • Alternative Names
    • Hair shaft fracture; Brittle hair; Fragile hair; Hair breakage

  • Causes
    • Trichorrhexis nodosa can be an inherited condition.

      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:

      • Thyroid not making enough thyroid hormone (hypothyroidism)
      • Buildup of ammonia in the body (argininosuccinic aciduria)
      • Iron deficiency
      • Menkes syndrome (Menkes kinky hair syndrome)
      • Group of conditions in which there is abnormal development of the skin, hair, nails, teeth, or sweat glands (ectodermal dysplasia)
      • Trichothiodystrophy (inherited disorder that causes brittle hair, skin problems, and intellectual disability)
  • 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 White, 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
    • The health care provider will examine your hair and scalp. Some of your hairs will be checked under a microscope.

      Blood tests may be ordered to check for anemia, thyroid disease, and other conditions.

  • Treatment
    • If you have a disorder that is causing your trichorrhexis nodosa, it will be treated.

      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
  • 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.

  • When to Contact a Medical Professional
    • Call your provider if symptoms do not improve with changes in grooming and other home-care measures.

  • References
    • Habif TP. Hair diseases. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier Mosby; 2016:chap 24.

      Patterson JW. Diseases of cutaneous appendages. In: Patterson JW, ed. Weedon's Skin Pathology. 4th ed. Philadelphia, PA: Elsevier; 2015:chap 15.