Medical Care

The systemic administration of vitamins, retinoids, griseofulvin, oral contraceptives, steroids, radiation therapy and external desquamative ointments, steroid preparations, and minoxidil does not show impressive results. A 7-year-old girl treated with oral acitretin had good clinical and cosmetic results, but clinical symptoms recurred after discontinuation of acitretin therapy.^[33]

The avoidance of trauma is the most effective method of managing this anomaly. Congenitally abnormal hair tends to have an increased susceptibility to weathering and cosmetic damage (eg, sunlight exposure, dyeing, bleaching, perming, curling), which can prevent hair from growing to its maximum length.

No definitive therapy is recognized, but topical minoxidil 2% (1 mL night and day for 1 y) led to an increase of normal hair shaft without any adverse effects in 1 report. Topical minoxidil 2% may be a good therapeutic option to treat monilethrix,^[34]although its use in children may require enhanced monitoring.^[35] Oral minoxidil treatment is another option.^[36]

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Media Gallery

Lusterless, dry, brittle hair with alopecia and keratosis pilaris mainly on the occiput. The hair of this 4-year-old boy was never cut.
Photomicrograph shows the regular nodes and internodes of the hair shaft in monilethrix, or pili moniliformes (original magnification X200).
Photomicrograph shows the regular nodes and internodes of the hair shaft in monilethrix, or pili moniliformes (original magnification X200).
Monilethrix that affects the entire scalp.
Monilethrix that affects the entire scalp.

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Author

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Coauthor(s)

Malgorzata Alexiewicz-Slowinska, MD Consulting Dermatologist, Group Medical Practice, Poznan, Poland

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Camila K Janniger, MD Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, Rutgers New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Carrie L Kovarik, MD Assistant Professor of Dermatology, Dermatopathology, and Infectious Diseases, University of Pennsylvania School of Medicine

Carrie L Kovarik, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Dr. Marek Kazmierowski and Dr. Gosiunia Alexiewicz-Slowinsk, to the development and writing of this article.

Monilethrix Treatment & Management

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