Weathering of hair in trichoteiromania

Abstract

A 74-year-old woman presented with an 18-month history of broken vertex scalp hairs as a consequence of chronic rubbing. Light microscopy of the 1-2 cm hairs demonstrated distal brush-like splitting. Education and behavioural therapy were instituted. After 4 months of reduced rubbing of the vertex scalp hairs, the hairs re-grew with no evidence of persistent hair shaft abnormality.

A Case of Friction Alopecia in a Healthy 15-Year-Old Girl

“…The hallmark feature of trichoteiromania is short, broken hairs with split, brush-like ends giving the appearance of white tips macroscopically [1]. This is the result of repetitive rubbing that gradually erodes the cuticular cell margins in the distal shaft (where they are less adherent) [1,3]. This brushlike splitting is not reported in trichotillomania (pulling of the hair) or trichotemnomania (cutting of the hair), differentiating trichoteiromania from the other self-induced alopecias [1].…”

“…This is the result of repetitive rubbing that gradually erodes the cuticular cell margins in the distal shaft (where they are less adherent) [1,3]. This brushlike splitting is not reported in trichotillomania (pulling of the hair) or trichotemnomania (cutting of the hair), differentiating trichoteiromania from the other self-induced alopecias [1]. Other potential findings include broken hair shafts of varying lengths and slight erythema in the areas affected [4].…”

“…Friction alopecia is hair loss secondary to frequent rubbing of the hair, which leads to hair breakage at different levels and splitting at the ends [1,2]. It is a non-scarring alopecia that can be caused by a self-inflicting tic disorder or a foreign object rubbing on the hairs.…”

“…When it is self-inflicting, friction alopecia is referred to as trichoteiromania ("teiro" from the Greek derivation meaning "I rub"), a psychiatric disorder characterized by compulsive rubbing of the hair [1,3]. The hallmark feature of trichoteiromania is short, broken hairs with split, brush-like ends giving the appearance of white tips macroscopically [1].…”

“…The hallmark feature of trichoteiromania is short, broken hairs with split, brush-like ends giving the appearance of white tips macroscopically [1]. This is the result of repetitive rubbing that gradually erodes the cuticular cell margins in the distal shaft (where they are less adherent) [1,3].…”