The Greening of Hair: A Unique Case of Chlorotrichosis and Its Management

Abstract

<b><i>Introduction:</i></b> Chlorotrichosis, commonly known as “green hair,” is an unusual trichological condition characterized by the accumulation of exogenous copper in individuals with light-colored hair and prior hair damage. It is primarily associated with inadequately maintained swimming pools. <b><i>Case Presentation:</i></b> We report a case of chlorotrichosis in a 16-year-old female who presented with a sudden and pronounced change in hair color after initiating regular swimming. Clinical examination revealed a distinctive greenish discoloration, primarily affecting the distal portions of her hair. The diagnosis of chlorotrichosis was confirmed based on clinical presentation and history. Treatment involved the use of an ethylenediaminetetraacetic acid (EDTA)-containing shampoo, leading to significant pigmentation regression within 8 weeks. Additionally, preventive measures included the application of a quaternary ammonium-enriched conditioner before exposure to copper-rich environments. <b><i>Discussion/Conclusion:</i></b> Chlorotrichosis remains underreported and potentially underdiagnosed, partly due to its cosmetic nature. Various factors, including occupational copper exposure and serum extravasation containing dipyridamole, have been associated with green hair. Treatment options encompass the use of EDTA-containing shampoos, among others. Dermatologists should be knowledgeable about its causes, predisposing factors, and effective management to enhance the diagnosis and treatment of this distinctive hair disorder.