Trichorrhexis Nodosa: Causes and Treatment
August 27, 2021 | Farah Jassawalla

Trichorrhexis Nodosa: Causes and Treatment

When an individual’s immune system starts attacking the hair follicles i.e. the cellular structure under the scalp from where the hair grows, it causes the hair to fall out. This condition is called alopecia areata. This hair loss is sudden and occurs in small patches. Primarily, these patches are not easily noticed. But when the hair loss continues, the patches on the scalp grow wider and become noticeable.

This condition of sudden hair loss may extend from the scalp to losing hair from all parts of the body, even eyebrows and eyelashes. In some cases, the hair may grow back only to fall out again after some time. Sometimes it recurs after years, but sometimes it may happen after months. The extent of hair loss and its regrowth varies from person to person.


Alopecia areata is an autoimmune condition and is mostly genetic. Individuals with this alopecia areata may have family antecedents with autoimmune diseases like diabetes. Although the exact cause of this condition is still unknown.

The autoimmune system works in such a way that it attacks anything that it considers foreign to protect the body from harmful substances like bacteria and viruses. So, in this case, the immune system attacks the newly made healthy cells of the body, including the hair follicles in the scalp and overall skin. When these hair follicles are attacked, they shrink and are unable to protect hair from falling or grow new hair out of them, resulting in hair loss.


Even though the main symptom for this condition is hair loss, it is not the only symptom to diagnose alopecia areata. Other symptoms include red patches on the skin, red and brittle nails, patchy beard, no hair growth, etc. Hair loss in alopecia areata occurs in small patches of about a few centimeters. The hair fall may be noticed in the shower, on pillows, etc. Although, it takes months to notice obvious symptoms.

In rare cases, the hair loss is extensive, and the whole body suffers from it within weeks. The loss of eyebrows and eyelashes, chest and other bodily hair falls out within a few days which can be depressing and stressful for the patient.

Losing all hair on the scalp is termed alopecia totalis. However, losing all hair on the scalp as well as the whole body is called alopecia universalis.

Also, the hair loss in this condition is different from other hair problems and conditions. male-pattern baldness is the thinning of hair over time that happens due to aging, whereas, this condition occurs mostly in young adults less than thirty years of age. Similarly, female-pattern baldness is the thinning of hair due to hormones and happens mostly around menopause while this condition’s cause is unknown, and hair loss occurs in patches.

Diagnosis and Treatment

Alopecia areata is diagnosed by ruling out other hair problems like fungal infections, and bamboo hair, etc. by performing a scalp biopsy. Also, a few blood tests and DNA tests are done to check other autoimmune conditions and family inheritance genes.

Its treatment includes some steroid injections and ointments to rub on the scalp for regrowth of hair, and oral medications like immunosuppressants to decrease immune system strength, stimulate hair growth and reduce hair loss.

However, these treatments should not be used for long as they do not ensure the possibility of recurrence of this condition and increase the risk for other diseases like cancer, high blood pressure, and liver and kidney problems. Get in touch with professionals for an online appointment at Shifa4U.

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Farah Jassawalla

Farah Jassawalla is a graduate of the Lahore School of Economics. She is also a writer, and healthcare enthusiast, having closely observed case studies while working with Lahore's thriving general physicians at their clinics.