Prepubertal hypertrichosis is a medical condition characterized by excessive hair growth in children before the onset of puberty. It is a relatively rare condition that can affect both males and females but is more commonly seen in females.
There are several different types of prepubertal hypertrichosis, each with its own set of symptoms, causes, and treatment options.
- Congenital Hypertrichosis Terminalis (CHT)
Congenital hypertrichosis terminalis (CHT) is a genetic condition that is present from birth. It is characterized by the presence of long, thick terminal hairs on the face, neck, arms, and trunk. The hair growth is usually symmetrical and may spread to the scalp and other parts of the body as the child grows older. CHT is caused by a genetic mutation that affects the regulation of hair growth.
- Acquired Hypertrichosis Lanuginosa (AHL)
Acquired hypertrichosis lanuginosa (AHL) is a condition that develops after birth and is characterized by the sudden appearance of fine, downy hair on the face, neck, and trunk. This type of hypertrichosis is often associated with certain medical conditions, such as hormonal imbalances, autoimmune disorders, and certain medications. In some cases, AHL may resolve on its own, but in others, it may persist for the rest of the patient’s life.
- Hypertrichosis Universalis (HU)
Hypertrichosis universalis (HU) is a rare condition that is characterized by excessive hair growth all over the body, including the face, scalp, and extremities. This type of hypertrichosis is caused by a genetic mutation that affects hair growth regulation. HU may be present from birth or may develop later in life.
- Acquired Generalized Hypertrichosis (AGH)
Acquired generalized hypertrichosis (AGH) is a condition that develops after birth and is characterized by the sudden appearance of thick, terminal hairs all over the body, including the face, scalp, and extremities. This type of hypertrichosis is often associated with certain medical conditions, such as hormonal imbalances, autoimmune disorders, and certain medications. In some cases, AGH may resolve on its own, but in others, it may persist for the rest of the patient’s life.
Causes
There are several causes of prepubertal hypertrichosis, including genetic disorders, hormonal imbalances, and certain medications.
- Genetic Disorders: One of the most common causes of prepubertal hypertrichosis is genetic disorders. These disorders are inherited from one or both parents and are caused by mutations in specific genes. Some of the most well-known genetic disorders that can cause prepubertal hypertrichosis include:
- Congenital Hypertrichosis Terminalis (CHT): CHT is a rare genetic disorder that is characterized by excessive hair growth on the face, neck, and trunk. This condition is caused by a mutation in the genes responsible for hair growth and is passed down from generation to generation.
- Ambras Syndrome: Ambras syndrome is a rare genetic disorder that is characterized by excessive hair growth on the face, neck, and body. It is caused by a mutation in the gene responsible for hair growth and is usually inherited in an autosomal dominant pattern.
- Hypertrichosis Lanuginosa Acquisita (HLA): HLA is a rare genetic disorder that is characterized by excessive hair growth on the face, neck, and body. It is caused by a mutation in the gene responsible for hair growth and is usually inherited in an autosomal dominant pattern.
- Hormonal Imbalances: Hormonal imbalances can also cause prepubertal hypertrichosis. Hormones play a crucial role in regulating hair growth, and imbalances can cause excessive hair growth in children. Some of the most common hormonal imbalances that can cause prepubertal hypertrichosis include:
- Polycystic Ovary Syndrome (PCOS): PCOS is a common hormonal disorder that affects women. It is characterized by an imbalance of hormones, including androgens (male hormones), which can cause excessive hair growth on the face, neck, and body.
- Hyperandrogenism: Hyperandrogenism is a condition characterized by high levels of androgens in the body. This hormonal imbalance can cause excessive hair growth on the face, neck, and body in both males and females.
- Thyroid Disorders: Thyroid disorders, such as hyperthyroidism and hypothyroidism, can also cause hormonal imbalances that can result in prepubertal hypertrichosis.
- Medications: Certain medications can also cause prepubertal hypertrichosis as a side effect. These medications include:
- Corticosteroids: Corticosteroids are a type of medication that are commonly used to treat a variety of medical conditions, including inflammation and autoimmune disorders. However, long-term use of corticosteroids can cause excessive hair growth on the face, neck, and body.
- Anticonvulsants: Anticonvulsants are a type of medication that are commonly used to treat seizures and other neurological conditions. However, long-term use of anticonvulsants can cause excessive hair growth on the face, neck, and body.
- Hormonal Therapy: Hormonal therapy, such as testosterone replacement therapy, can also cause excessive hair growth on the face, neck, and body.
Symptoms
The following is a list of symptoms associated with prepubertal hypertrichosis:
- Excessive hair growth: The most obvious symptom of prepubertal hypertrichosis is excessive hair growth in areas of the body where hair is typically not found, such as the face, neck, and arms. This hair can be fine or thick and may have a different color or texture than the hair on the head.
- Early onset of puberty: Children with prepubertal hypertrichosis may show signs of puberty earlier than other children their age, such as breast development or the onset of menstruation.
- Hormonal imbalances: Children with prepubertal hypertrichosis may experience hormonal imbalances, such as elevated levels of androgens (male hormones) or decreased levels of estrogens (female hormones). This can result in a variety of symptoms, including acne, irregular menstrual cycles, and mood swings.
- Delayed development: In some cases, children with prepubertal hypertrichosis may experience delayed growth and development, such as the delayed onset of puberty or slow growth in height.
- Psychological distress: The excessive hair growth associated with prepubertal hypertrichosis can lead to psychological distress and social isolation for children. They may feel self-conscious about their appearance and may experience bullying or teasing from their peers.
- Skin irritation: The excessive hair growth associated with prepubertal hypertrichosis can cause skin irritation, as the hair can trap moisture and dirt, leading to rashes and infections.
- Abnormal hair patterns: Children with prepubertal hypertrichosis may have abnormal hair patterns, such as patches of hair that are missing or hair that is growing in a spiral pattern.
- Vision problems: In some cases, the excessive hair growth associated with prepubertal hypertrichosis can interfere with vision, as the hair can grow into the eyes and cause irritation or block vision.
- Pain or discomfort: Children with prepubertal hypertrichosis may experience pain or discomfort as a result of excessive hair growth, such as itching, burning, or skin irritation.
Diagnosis
Diagnosis of prepubertal hypertrichosis typically begins with a physical examination and a detailed medical history. During the physical examination, the doctor will examine the child’s skin, hair, and nails to determine the extent and pattern of hair growth. The doctor may also take biopsy samples of the hair or skin to help determine the cause of the condition.
In addition to a physical examination, the following tests may be used to diagnose prepubertal hypertrichosis:
- Physical Exam: The first step in diagnosing prepubertal hypertrichosis is to perform a thorough physical examination. During the exam, the healthcare provider will closely examine the affected areas of the body, looking for signs of excessive hair growth. They may also ask the patient about any related symptoms, such as itching, skin irritation, or pain.
- Medical History: The healthcare provider will also ask the patient about their medical history, including any past or present medical conditions, surgeries, or medications. This information can help to identify any underlying medical conditions that may be contributing to hair growth.
- Blood tests: Blood tests can help determine if there are any underlying medical conditions that may be causing excessive hair growth. This may include tests for hormonal imbalances, such as hyperthyroidism or adrenal gland disorders.
- Skin tests: Skin tests can be used to determine if there is an underlying skin condition that is causing excessive hair growth. This may include a skin biopsy or a fungal culture.
- Genetic tests: Genetic tests can be used to determine if the child has a genetic condition that is causing excessive hair growth. This may include testing for genetic mutations or chromosomal abnormalities.
- Imaging tests: Imaging tests, such as an X-ray, CT scan, or MRI, can be used to determine if there are any underlying medical conditions that may be causing excessive hair growth. This may include checking for tumors or other growths that may be affecting the hair follicles.
Once a diagnosis of prepubertal hypertrichosis has been made, the doctor will work with the child and the child’s family to develop a treatment plan. Treatment options for prepubertal hypertrichosis may include medications, surgery, or lifestyle changes, depending on the cause of the condition.
Treatment
- Topical Medications: Topical medications, such as minoxidil, may be prescribed to slow down or stop the growth of excessive hair. These medications work by increasing blood flow to the hair follicles, which can help to promote hair growth.
- Hormonal Therapy: Hormonal therapy may be prescribed to correct any hormonal imbalances that may be contributing to excessive hair growth. This may include medications to regulate levels of testosterone, cortisol, or other hormones.
- Topical Medications: Topical medications, such as minoxidil and eflornithine, are commonly used to treat prepubertal hypertrichosis. Minoxidil is a vasodilator that is applied to the skin to increase blood flow and promote hair growth. Eflornithine is a topical cream that inhibits the production of hair-stimulating hormones, reducing the growth of facial hair. These medications can be applied directly to the affected areas and are safe and effective for most individuals with prepubertal hypertrichosis.
- Laser Hair Removal: Laser hair removal is a popular cosmetic procedure that involves the use of a laser to destroy hair follicles, reducing hair growth. This treatment is safe, effective, and long-lasting, and it can be performed on any area of the body, including the face. Laser hair removal can be performed in a doctor’s office or in a spa setting, and it typically requires multiple sessions for optimal results.
- Electrolysis: Electrolysis is a procedure that involves the use of an electric current to destroy hair follicles, reducing hair growth. This treatment is performed by a licensed electrologist and can be performed on any area of the body, including the face. Electrolysis is safe, effective, and long-lasting, but it can be time-consuming, and it typically requires multiple sessions for optimal results.
- Hormonal Therapy: In some cases, prepubertal hypertrichosis may be caused by hormonal imbalances, such as high levels of androgens (male hormones). Hormonal therapy can be used to reduce androgen levels and reduce hair growth. This treatment may involve the use of oral contraceptives, anti-androgens, or other medications that regulate hormones. Hormonal therapy is typically only recommended for individuals with hormonal imbalances that are contributing to their hypertrichosis.
- Surgical Excision: In severe cases of prepubertal hypertrichosis, surgical excision may be recommended. This procedure involves the removal of the affected hair-bearing skin, resulting in a permanent reduction in hair growth. Surgical excision is typically only recommended for individuals with severe hypertrichosis that is not responding to other treatments.
- Psychotherapy: Living with prepubertal hypertrichosis can be challenging, and individuals with this condition may experience low self-esteem, anxiety, and depression. Psychotherapy can help individuals cope with the emotional and psychological effects of this condition, improving their quality of life. Psychotherapy may involve individual or group therapy, and it can be performed by a licensed psychologist or counselor.
- Education and Support: Education and support are critical components of treating prepubertal hypertrichosis. Individuals with this condition, as well as their families, can benefit from learning about the condition, its causes, and its treatments. Support groups, online communities, and resources can also provide individuals with a sense of community and help them feel less isolated.
- Surgery: In severe cases of prepubertal hypertrichosis, surgical removal of the affected hair follicles may be recommended. This procedure is typically performed under general anesthesia and may involve the removal of hair follicles from several different areas of the body.
