Hair Casts

In the 1980 study "Hair Casts," Crovato, Rebora, and Crosti presented two cases of peripilar hair casts, which are fine, whitish nodular accretions of epithelial cells and keratinous debris surrounding the hair shafts. The first case involved a 32-year-old woman with a high telogen effluvium rate of 46% and a history of anxiety and depressive mood, who had shiny nodular accretions on her hair shafts. The second case was a 22-year-old woman with a telogen count of 40%, who had experienced hair loss after a weight reduction program and also had nodular accretions on her hair shafts. Both cases involved individuals who engaged in hair pulling or twisting. The study suggested that long-term or repetitive tractions from modern hair styling or moderate trichotillomania due to anxiety for hair loss could be causative factors for hair casts. The authors noted that hair casts are likely underreported and often misdiagnosed, and they emphasized that unlike other conditions such as nits or trichomycosis, hair casts can move freely along the hair shaft.