trichopathies

Trichopathies are disorders that affect the hair and hair follicles. The term covers a broad spectrum of conditions, including congenital hair shaft abnormalities and acquired disorders that cause fragility, abnormal growth, or shedding of hair. Clinical presentations range from brittle, easily breakable hair to diffuse thinning or patchy hair loss, often with characteristic hair shaft findings.

Many trichopathies arise from structural defects of the hair shaft. Examples include trichorrhexis nodosa (frayed or “broken” shafts with nodal damage), monilethrix (beaded hair with alternating thick and thin segments), pili torti (twisted or flattened shafts), and trichothiodystrophy (sulfur-poor, brittle hair with diagnostic banding under polarized light). Trichorrhexis invaginata (bamboo hair) occurs in specific syndromes. Other conditions reflect altered hair cycling or follicle function, such as telogen effluvium and certain patterns of hair loss linked to androgenetic factors or nutritional and metabolic problems.

Diagnosis relies on history and physical examination, supported by microscopic evaluation of plucked hairs, trichoscopy, and, when indicated, laboratory testing for nutritional, endocrine, or metabolic abnormalities as well as genetic testing for inherited forms.

Management is condition-specific and focuses on protecting hair integrity, treating underlying causes, and optimizing hair growth where possible. Measures include reducing mechanical trauma, avoiding irritants, correcting deficiencies, and using appropriate topical or systemic therapies as advised by a clinician. Many trichopathies are chronic and require multidisciplinary care and genetic counseling for inherited forms.