Trichorrhexis nodosa

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Trichorrhexis nodosa is a problem in which thickened or weak points (nodes) along the hair shaft cause your hair to break off easily.

Alternative Names

Hair shaft fracture; Brittle hair; Fragile hair; Hair breakage


Trichorrhexis nodosa can be an inherited condition.

Certain things you do to your hair such as blow-drying, over-brushing, perming, or excessive chemical use, appear to trigger the condition.

In some cases, trichorrhexis nodosa is caused be an underlying disorder, such as:

  • Thyroid not making enough thyroid hormone (hypothyroidism)
  • Buildup of ammonia in the body (argininosuccinic aciduria)
  • Iron deficiency
  • Menkes syndrome (Menkes kinky hair syndrome)
  • Group of conditions in which there is abnormal development of the skin, hair, nails, teeth, or sweat glands (ectodermal dysplasia)
  • Trichothiodystrophy (inherited disorder that causes brittle hair, skin problems, and intellectual disability)


Your hair may break easily or it may appear like it is not growing.

In African Americans, looking at the scalp area using a microscope shows that the hair breaks off at the scalp area before it grows long.

In White, the problem often appears at the end of a hair shaft in the form of split ends, thinning hair, and hair tips that look white.

Exams and Tests

The health care provider will examine your hair and scalp. Some of your hairs will be checked under a microscope.

Blood tests may be ordered to check for anemia, thyroid disease, and other conditions.


If you have a disorder that is causing your trichorrhexis nodosa, it will be treated.

Your provider may recommend measures to reduce damage to your hair such as:

  • Gentle brushing with a soft brush instead of aggressive brushing or ratting
  • Avoiding harsh chemicals such as those used in straightening compounds and perms
  • Not using a very hot hair dryer for long periods and not ironing the hair
  • Using a gentle shampoo and a hair conditioner

Outlook (Prognosis)

Improving grooming techniques and avoiding products that damage hair will help correct the problem.

This condition is not dangerous, but may affect a person's self-esteem.

When to Contact a Medical Professional

Call your provider if symptoms do not improve with changes in grooming and other home-care measures.


Habif TP. Hair diseases. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier Mosby; 2016:chap 24.

Patterson JW. Diseases of cutaneous appendages. In: Patterson JW, ed. Weedon's Skin Pathology. 4th ed. Philadelphia, PA: Elsevier; 2015:chap 15.

Version Info

  • Last reviewed on 4/14/2015
  • Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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