Monilethrix is a hair disorder which causes a beaded appearance of the hair due to fragile, short and broken hairs. The term monilethrix itself means beaded (monile) hair (thrix) and is a rare condition which is autosomal in nature. Usually the condition is present with other hair disorders like alopecia, nail anomalies, keratosis and hyperfollicular keratosis. Monilethrix treatment depends on the severity of symptoms and the extent of damage already done to the hair. Therefore, a differential diagnosis and determination of cause is important before proceeding to get monilethrix treatment.
Causes of Monilethrix
Hairs are made up of keratin protein and mutation in genes (KRTHB1, KRTHB3 and KRTHB6) that control keratin production is considered as the underlying cause for monilethrix condition. This genetic defect can be inherited if only one parent has the condition, as it is an autosomal dominant trait.
Monilethrix is not specifically observed in a particular hair color or hair type. It is generally onset during infancy itself and is equally observed in both men and women. Commonly observed symptoms are –
- Fragile hair, prone to dryness and lackluster appearance
- Beaded and brittle hair with nodes (thin points)
- Breakage of hair and different levels of alopecia
- Koilonychia or spoon shaped fingernails is an associated symptom
Monilethrix is largely observed in scalp area, thus effecting hairs on the head. Eyelashes, eyebrows, pubic hair, limb hair and axillary hair remain largely unaffected.
Trichorrhexis invaginata or Bamboo hair condition is a similar hair disorder, and monilethrix has to be differentially diagnosed from this condition. Trichologists can conduct a diagnosis by –
- Microscopic examination of the hair shaft
- If the internodes on hair shaft have a dense longitudinal pattern of scales and ridging, it is an indication of monilethrix. This can only be studied under electron microscope.
- Dermoscopy can also reveal intermittent constriction in the elliptical nodes of hair shaft. The propensity of hair to break, bend at multiple locations and fracture can be quickly diagnosed using this technique.
Once the condition has been diagnosed, treatment can be sought out from a trained trichologist. As it is a congenital condition, monilethrix can’t be permanently treated. But with minimal exposure to chemical and physical trauma, the condition can be managed. A therapeutic option for monilethrix treatment can be 2% topical minoxidil. When applied regularly for 1 year, 1 ml in the day and 1 ml in night, normal hair growth can be enhanced.
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