International Journal of Trichology International Journal of Trichology
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 Table of Contents  
Year : 2020  |  Volume : 12  |  Issue : 4  |  Page : 191-192  

Sudden hair change after first birthday

Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany

Date of Submission21-Mar-2020
Date of Acceptance21-Jul-2020
Date of Web Publication19-Sep-2020

Correspondence Address:
Dr. Ines Bertlich
Department of Dermatology, University Hospital Heidelberg, Heidelberg
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijt.ijt_36_20

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How to cite this article:
Bertlich I, Hartschuh W, Enk A, Toberer F. Sudden hair change after first birthday. Int J Trichol 2020;12:191-2

How to cite this URL:
Bertlich I, Hartschuh W, Enk A, Toberer F. Sudden hair change after first birthday. Int J Trichol [serial online] 2020 [cited 2023 Jan 31];12:191-2. Available from: https://www.ijtrichology.com/text.asp?2020/12/4/191/295407

   Medical History Top

A 2-year-old boy presented with his parents to our outpatient department because his hair had gradually turned rough and dry after his first birthday. The boy had short, straight, dark-blond, “straw-like,” and tousled hair. The mother had not noticed brittleness. He had a ring of lighter colored hair around his vertex [Figure 1]a. He did not show any other anomalies of the teeth, hair, nails, or sweat glands. He was a single child and had no relevant medical record except for a mild plagiocephalus of the right scull due to the chosen lying position that self-resolved at the age of 3 months. Furthermore, he had suffered from a streptococcal sepsis with reactive arthritis of the hips, elbows, and knees at the age of 6 months.
Figure 1: (a) The patient's “Straw-like” and tousled hair upon presentation. (b) HE-stain of the patient's hair shaft in light microscopy analysis. (c) HE-stain of a healthy person's hair shaft in light microscopy analysis

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   Diagnostic Findings Top

We performed a light microscopy evaluation of the patient's hair shaft and of a healthy person's hair shaft [Figure 1]b and c]. The hair of the healthy person showed a normal oval contour, while the patient's hair showed a triangular-shaped profile and longitudinal grooves along the shaft [Figure 1]b.

   What Is Your Diagnosis? Top


We diagnosed pili trianguli et canaliculi (syndrome of uncombable hair or “spun glass hair”); a hair shaft anomaly that is caused by dysfunctional skin papillae that lead to an abnormal keratinization in the root sheath of the hair. The syndrome occurs sporadic and less frequently, with autosomal-dominant or autosomal-recessive inheritance. It can rarely be associated with ectodermal dysplasia.[1] The hair turns rough and dry at the age between 3 and 12 months. In contrast to other hair shaft disorders, the amount of hair does not diminish as there is no hair loss or brittleness.[2]

The syndrome does not require treatment as it often resolves in late childhood.[3]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given his consent for images and other clinical information to be reported in the journal. The guardian understands that names and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.


We would like to thank Dr. rer. nat. Ingrid Haußer-Siller for her contribution to this manuscript.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

   References Top

Silengo M, Lerone M, Romeo G, Calcagno E, Martucciello G, Jasonni V. Uncombable hair, retinal pigmentary dystrophy, dental anomalies, and brachydactyly: Report of a new patient with additional findings. Am J Med Genet 1993;47:931-3.  Back to cited text no. 1
Navarini A. Uncombable hair syndrome. Orphanet Encyclopedia; 2012.  Back to cited text no. 2
Itin PH, Fistarol SK. Hair shaft abnormalities--clues to diagnosis and treatment. Dermatology 2005;211:63-71.  Back to cited text no. 3


  [Figure 1]

This article has been cited by
1 Uncombable hair syndrome and beyond
Manahel Mahmood Alsabbagh
Acta Dermatovenerologica Alpina Pannonica et Adriatica. 2022; 31(2)
[Pubmed] | [DOI]


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