Structural changes in hair shaft can be a part of a bouquet of symptoms presenting clinically. Changes in hair shaft over a large area of scalp can cause alopecia, frizzy woolly hair or at times may go completely undetected unless examined microscopically.
TRICHORRHEXIS NODOSA (TN)
Trichorrhexis nodosa is the most common defect of the hair shaft. In general, trichorrhexis nodosa is often found in patients complaining of increased fragility of hair.
Most common hair shaft problem which is longitudinal splitting of hair shaft or split ends. Rigorous brushing or physical and chemical trauma can result in to Trichoptillosis.
Monilethrix is a rare, hereditary hair shaft anomaly in which the diameter of the hair fluctuates at regular intervals so that, under the microscope, the hair looks similar to the strings of beads. Due to its distinct morphology resembling a pearl necklace the name derived from the Latin word “monile” (necklace) and the Greek word “thrix” (hair).
Pseudomonilethrix has been classified in three different types: I) familiar pseudomonilethrix of Bentley- Phillips (autosomal-dominant inheritance);
II) Acquired pseudomonilethrix in dysplastic disorders with hair fragility (inheritance profile depending on the dysplastic disorder);
III) Iatrogenic pseudomonilethrix.
Pseudomonilethrix, a developmental hair shaft defect, is characterized by irregular nodes along the hair shaft, with fragility and breakage of hair resulting in partial baldness.
(Knotting of hair) Seen in curly hair can either be genetic or acquired due to trauma. It does not bear any clinical significance.
Trichorrhexis Invaginata-(Nethertons syndrome) Trichorrhexis invaginata (also known as “Bamboo hair”) is a distinctive hair shaft abnormality that may occur sporadically, either in normal hair or with other hair shaft abnormalities, or regularly as a marker for Netherton’s syndrome.
This condition is always associated with copper in the hair in some form and tends to affect bleached hair. This condition is never seen in black hair, as the green becomes lost in the background color. Green hair may be a result of over-exposure to swimming pool water, where chloride treatment or copper algaecides are used. Green hair may also stem from high levels of copper in domestic water pipes. In a house that has both old iron water pipes and new copper ones, the drinking water has increased copper levels. Green hair can also result from a good long soak in a bath that has been cleaned with old bathroom cleaners containing high chloride levels sometimes; it is the result of using bleach.
Our Approach- To classify if the disorder is genetic or acquired. Acquired disorders can be treated and a permanent cure can be given but even for genetic problems hair care can be suggested.
When we see genetic anomaly of hair, any other congenital anomalies or syndromes are always ruled out. Many times we have been able to guide a patient for a opinion on genetic problem.
Acquired hair shaft problem like TN, Spilt ends, Green hair etc are treated symptomatically educating patient on hair care and if needed therapies for hydrating hair can be given.
Along with external care internal supplements may also be needed for synthesis of healthy hair.