International Journal of Trichology

: 2020  |  Volume : 12  |  Issue : 4  |  Page : 191--192

Sudden hair change after first birthday

Ines Bertlich, Wolfgang Hartschuh, Alexander Enk, Ferdinand Toberer 
 Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany

Correspondence Address:
Dr. Ines Bertlich
Department of Dermatology, University Hospital Heidelberg, Heidelberg

How to cite this article:
Bertlich I, Hartschuh W, Enk A, Toberer F. Sudden hair change after first birthday.Int J Trichol 2020;12:191-192

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 30 ];12:191-192
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 Medical History

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}

 Diagnostic Findings

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?


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.


1Silengo 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.
2Navarini A. Uncombable hair syndrome. Orphanet Encyclopedia; 2012.
3Itin PH, Fistarol SK. Hair shaft abnormalities--clues to diagnosis and treatment. Dermatology 2005;211:63-71.