Hair Shaft Defects

Listed (A-Z) below is a summary of hair shaft defects.


This is an uncommon disorder of terminal and vellus hair of the scalp. It disfigures the structure of a hair strand, in certain targeted regions of the scalp. The characteristics will appear after a slight altering of the hair follicle structure, which will reduce hair growth in certain cases. The hair shaft texture becomes brittle, dull, dry and tightly curled at the bottom with severe kinking resembling woolly hair or pubic hair. There are some noticeable abnormalities of pigmentation, whether hyperpigmentation which results in a darker colour or hypopigmentation which results in a lighter colour. The most affected regions of the scalp are the frontal, temporal, vertex and occipital regions. At this stage the affected hair strands are pushed prematurely from the anagen phase into the telogen, which results in abnormal shedding that may be noticeable. Please call our helpline for more information.

This is an acquired deformity within the hair shaft, which occurs as a result of the use of excessive heat and chemicals. This will result in the formation of blisters and bubbles within the hair. Please contact our clinic for help.

Loss of melanin (pigment) from the hair can be grouped into 3 major different categories, though there can be more.

i) Canities is the state of diminishing melanin from the hair bulb, causing a change of hair colour to white. This happens as a gradual process with age. Statistically Caucasians have shown the earliest signs of greying which has been known to start as early as the mid-thirties while in Asian ethnicities this begins in the forties.

ii) Canities Subita is an abnormal and rapid loss of pigment towards white hair. It is associated with acute alopecia areata, stress and trauma. The anagen hair bulb becomes vulnerable to immune attack during alopecia areata. However this can only happen to the pigmented hair, which will result in preferential loss of pigmented hair leaving behind only white hair.

iii) Leucotrichia; this is a Greek word meaning white hair or white tail. This is a pigment disorder targeting the epidermal layer, where the melanocytes reside. The condition happens as a result of an autoimmune disorder and also an imbalance of oxygen in stressed skin. This is also associated with vitiligo, which is a condition that causes the complete loss of pigmentation in patches on the skin and hair.

iv) Poliosis is the hereditary absence or decrease of melanin on areas of the hair, skin, eyelashes and eyebrows. Albinism is complete poliosis, i.e. the absence of melanin from all areas of the skin.

v) Environment or infection; melanin disorders could also follow an injury or event like herpes zoster (shingles) or radiotherapy, in this case the melanocytes have been damaged beyond repair. Please contact our helpline for more information.

This is a very rare condition that happens as a result of damage to the hair shaft, however the cause is still unknown hence 'idiopathic'. The condition presents itself with trichorrhexis nodosa, which would be very near to the scalp, but limited to 6mm in length. Hair loss also occurs leaving oval patches where broken hair shafts are found. The patches appear at the vertex of the head or the anterior parietal region. The skin around these areas can be lichenified meaning it appears thickened or leathery, normally this happens due to excessive rubbing. This condition can affect any gender at any age and is usually self-limiting, but it can recur. Please call our helpline for more information.

This is a rare condition that presents as elliptical nodes along the hair shaft, resembling beads on a string, which is why the condition is sometimes referred to as 'beaded hair'. The hair is very fragile and will remain short as it rarely reaches 2 cm before breaking between the nodes. This is a genetic condition that may also present with alopecia, abnormal nail growth and follicular hyperkeratosis (corneous plugs). Please contact our clinic for more information.

This describes the condition of lice infestation on the scalp and hair shaft. These are tiny parasitic creatures that thrive on human blood, which they extract through the scalp or other parts of the body. This can be spread from person to person from sharing clothes and bedding or close contact. The symptoms are itching, redness and the sensation or feeling of crawling creatures on the scalp. Please contact our clinic for more information.

This is a rare condition, whereby the hair shaft gets irreversibly entwined together or permanently matted. The condition usually occurs as a result of damaged cuticles, which is the outermost layer of the hair shaft that covers and protects the hair cortex. Whenever the cortex layer is left exposed, the hair shaft is prone to damage and this causes the hair shaft to become sticky and porous, resulting in the formation of large chunks of knots, which can emit an odour. Plica polonica is commonly seen after head lice infestation. Some of the clinical features can be an inflamed scalp, itchiness as well as moist and irreversible masses of tangled and intertwined knots. Damaged cuticles from the affected region can be observed under a dermascope. Please contact our clinic for more information.

This condition most often affects Afroid women from middle age. The condition is caused by certain hairstyles that injure and damage the hair follicle, resulting in permanent hair loss. These styles could be cornrows, weaving, braids and tight ponytails. Please contact our helpline for more information.

The other name for this condition is 'corkscrew hair'; it is an uncommon hair shaft disorder that is represented by twists that appear on a single hair strand. Trichokinesis can be congenital, acquired or associated with a number of underlying diseases. The onset can be early and is common in children, though it can affect mature and elderly people also. Eyebrows, eyelashes and axillary hair can also be affected and most of the affected hair will be fragile and this will lead to breakage. Please contact our clinic to speak to the consultant.

This is a defect or deformity of the hair shaft that can also be referred to as Pollitt syndrome. The condition occurs as a response to physical damage from the excessive use of chemicals or heat but it can be inherited or triggered by underlying diseases. Cuticles play the major role of hair shaft protection by covering the cortex layer from damage. Whenever cuticles get damaged they open up, leaving the cortex layer exposed and vulnerable. The exposed areas of the cortex will then expand or swell, thereby creating nodes. The nodes will eventually explode, leaving the hair fibres in shreds. Breaking of the hair shaft will follow this process. Pubic hair and beard hair can also be affected. This condition can also affect all ages, depending with what triggers it. Afroid people are most affected by Trichorrhexis nodosa. Please contact our clinic for more information.

This is a self-inflicted hair shaft disorder that is represented by excessive splitting at the ends of the terminal hair. The name also defines it, because it comes from the Greek 'tricho' meaning 'hair' and 'ptilosis' which is the Latin name for 'feathers'. Trichoptilosis occurs as a result of mechanical, thermal and chemical damage. Please arrange for a meeting with our consultant for more information.

This is a hair shaft disorder that presents itself as knots on individual strands of the terminal hair. These knots will appear intertwined, twisted or coiled. Trichonodosis is a rare condition that can affect any hair type and it is a condition that can arise from any age. Terminal hair of the scalp is the most affected but other areas like axillary hair and genital hair can also be affected. Please contact our clinic for more information.

This is one of the compulsive trichoses disorders that more often affects girls and women. This is an anxiety induced compulsive condition whereby patients pull hair out of their own scalp, eyebrows and eyelash hairs. The pulling will cause distress and damage to the hair follicles, which will result in temporal hair loss. This condition can be triggered by depression, anxiety, stress, psychiatric problems or other underlying conditions. Please contact our clinic for more information.

This is caused by a bacterial infection and affects mostly axillary hair (armpits) and genital hair. These are the areas that can provide the moist and warm environment needed for the bacteria to multiply. The bacteria will then secrete some substances that become adhesive. This will grow, spreading into a thick, yellow or black sticky layer that has an unpleasant smell. The condition is more common in teenagers and can be triggered by hot temperatures. Please contact our clinic for help.

This a compulsive disorder, that is characterised by compulsive rubbing or scratching of the scalp. The affected hair will be damaged, evidenced by fracturing and splitting of the ends. There could also be bald spots in severe cases but there is no permanent hair loss in Trichoteiromania. This is a condition that again affects mostly patients with psychiatric disorders. Please contact our clinic for more information.

This is a compulsive disorder that causes a patient to shave hair from the scalp, axillary, genitalia and eyebrows. This condition can be classified as a psychiatric or behavioural disorder that is triggered by stress. Patients affected with such a condition will develop an obsession with cutting hair even when hair growth is unnoticeable. The shaved scalp will end up looking bald and shiny like a patient affected with alopecia totalis or alopecia universalis. Please call our helpline for advice.

Trichophagia is a word originating from the Greek terms 'tricho' meaning hair and 'phagia', derived from 'phagein' which means 'to eat'. This is the psychological disorder of compulsive pulling and eating of the hair shaft. Patients affected with this condition will feel the urge to pluck the hair, chew it and even swallow the hair. The patient will normally focus on the hair shaft. Please contact our clinic for more information.

This is a genetic defect of hair shaft that is characterised by dry and frizzy hair that will not flatten upon application of a comb. The hair is also light blonde in colour and shiny. The condition affects Caucasoid children between 3 and 12 years of age. It is usually self-corrective after this. Please contact our clinic for more advice.

This a hereditary type of hair shaft deformity and can be associated with certain underlying conditions in some cases. The underlying diseases could be loose hair anagen syndrome, heart problems, nerve problems and a few others. This is a rare condition that affects Caucasian and Asian hair shafts; with distinguishable characteristics of curly, brittle, twisted, kinky and frizzy hair. Woolly hair syndrome resembles the African type of hair shaft and it can be difficult to comb. This condition can affect the entire hair shaft of the scalp or certain targeted regions of the scalp. The signs of woolly hair can be present at birth but the adolescent are the most affected. These symptoms of woolly hair can reduce to wavy hair as the person grows older. Please contact our clinic for more information.

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