Acquired Progressive Kinking of the Hair in a Korean Female Adolescent

A 12-year-old Korean girl presented with acquired progressive kinking of the hair (APKH), which began at age 8, with kinky hair developing in the parietal and temporal regions. She had no family history of hair disorders, systemic diseases, trauma, or exposure to harmful agents, and her routine laboratory findings were normal. Scanning electron microscopy (SEM) showed irregular entanglements and longitudinal twisting of the hair, which was oval-shaped in cross-section. A scalp biopsy showed non-specific findings, and she received only nutritional support. Two years later, there was no hair thinning or androgenetic alopecia. APKH typically starts around puberty and is characterized by patches of curly hair with the distal part of the hair shaft twisted in contrast to the nearly straight proximal part. The etiology of APKH is unclear, and it is not always associated with androgenetic alopecia, particularly in prepubertal females. The condition should be differentiated from congenital hair abnormalities and other conditions like uncombable hair syndrome. There are no effective treatments for APKH, but topical minoxidil is considered an alternative, although it generally does not prevent androgenetic alopecia.