Trichorrhexis nodosa L67.0

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 01.04.2022

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Hair nodule disease; Hodara disease; Hodar's disease; Paxton's disease; Trichonodose

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Wilks 1859; Beigel 1855;

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Acquired or (more rarely) congenital nodular hair shaft alteration with dull, rough, split, easily broken hair.

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Causally, defects in the cuticle lead to loss of cortical cells and intercellular cementum and eventually to imcomplete shaft fractures. The phenomenon may be:

be congenital:

Or far more commonly acquired:

  • Physical or chemical noxae. Nodular hair shaft abnormalities may occur proximally (due to tight hair styles) or distally (after repeated chemical or mechanical hair procedures - e.g., hair bleaching, hair straightening). In African-Americans who straighten their natural hair frizz, the phenomenon is common (Haskin A et al. 2017).

Trichorrhexis nodosa is often combined with trichoptilosis.

Clinical features
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Periodic thickening of the hair shaft due to bristle-brush-like splintering of the hair.

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Elimination of possible exogenous causes, greasing of the hair with e.g. Ol. olivarum, see also trichoclasis.

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  1. Haskin A et al (2017) Breaking the cycle of hair breakage: pearls for the management of acquired trichorrhexis nodosa. J Dermatologist Treat 28:322-326.
  2. Hwang ST et al (2013) Trichorrhexis nodosa after hair transplantation: dermoscopic, pathologic and electron microscopy analyses. Dermatol Surgery 39: 1721-1724
  3. Kharkar V et al (2011) Trichorrhexis nodosa with nail dystrophy: diagnosis by dermoscopy. Int J Trichology 3:105-106
  4. Lünnemann L et al (2013) Hair-shaft abnormality in a 7-year-old girl. Trichorrhexis nodosa dueto biotinidase deficiency. JAMA Dermatol 149:357-363
  5. Ogunbiyi A et al.(2014) Recurrent hair loss resulting from generalized proximal trichorrhexis nodosa in a Nigerian female. Int J Trichology 6:83-84
  6. Sisto T et al (2015) Inability to grow long hair: a presentation of trichorrhexis nodosa. Cutis 95:E15-16


Please ask your physician for a reliable diagnosis. This website is only meant as a reference.


Last updated on: 01.04.2022