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People with trichotillomania often pull only one hair at a time and these hair-pulling episodes can last for hours at a time. Some individuals may experience more satisfaction after pulling an anagen phase hair with the gel-like inner root sheath still surrounding the base of the hair.
The hair shaft has been reported as thin for some cases and normally structured for other loose anagen syndrome reports. [12] The inner root sheath of normal anagen hairs usually do not have keratin in the Huxley cells, Henle cells and inner root sheath. They are usually organised in an orderly manner and densely compacted.
Once the hair has been pulled out, persons with trichophagia might rub the hair against their lips, roll the hairs around and inspect them, bite off and swallow the bulb of the hair, or ingest the entire hair shaft as well. [9] Typically, ingested hair remains asymptomatic and is not harmful.
"During this phase, hair growth stops, and the outer root sheath shrinks and attaches to the root of the hair," says Dr. Kinler. "This detachment is a natural process as the hair prepares to enter ...
Alopecia occurs for various reasons, including genetics, autoimmune disorders where the immune system attacks hair follicles, hormonal changes, medical treatments like chemotherapy, or other factors.
The external root sheath appears empty with cuboid cells when stained with H&E stain. The internal root sheath is composed of three layers, Henle's layer, Huxley's layer, and an internal cuticle that is continuous with the outermost layer of the hair fiber. The bulge is located in the outer root sheath at the insertion point of the arrector ...
Pili multigemini, also known as "compound hairs," [2] is a malformation characterized by the presence of bifurcated or multiple divided hair matrices and papillae, giving rise to the formation of multiple hair shafts within the individual follicles. [3] [4]
The mechanism of pathology of CCCA remains unknown; thus, the cause has only been postulated and not proven. CCCA is suspected to have a multi-factored cause. [2] However, one theory involves pressure exerted on the internal root sheath leading to damage, which leads to the recruitment of inflammatory cells and the result of scarring.