Trichorrhexis Invaginata: A Comprehensive Guide

Trichorrhexis invaginata is one of the characteristic signs of a rare hereditary disorder. Because of how it looks, this hair shaft abnormality is also referred to as “bamboo” hair. 

But aside from the presence of bamboo-like nodes, this kind of hair tends to be sparse and easily broken. It’s also unable to grow beyond just a few centimetres.

Unfortunately, because of the genetic basis of this hair shaft disorder, it cannot be cured. Still, there are some treatments that might help improve the condition of your hair. 

This guide will help you understand trichorrhexis invaginata in more detail and what you can do about it. 

What Is Trichorrhexis Invaginata? 

Trichorrhexis invaginata is a hair shaft abnormality in which the distal end (towards the tip) of the hair invaginates (or encloses) around the proximal end (towards the root). 

Trichorrhexis invaginata

As a result, a ball-and-socket joint-type formation is seen on the hair, and if it breaks from there, it ends up looking like a golf tee (the thing on which the ball is placed in golf). 

Because these nodes end up resembling the nodes on a bamboo plant, it’s also known as “bamboo hair.”

Bamboo hair

Here, it should be noted that trichorrhexis invaginata co-occurs with skin and immune issues in a rare genetic disorder known as Netherton syndrome – named after Earl Netherton, who first described it in 1958. 

In trichorrhexis invaginata, your hair can become: 

  • Rough 
  • Dry 
  • Lustreless
  • Brittle
  • Spiky 
  • Easily breakable 
  • Thin and fine
  • Short and sparse 

According to a case report published in the Indian Journal of Paediatric Dermatology, this defect can affect anywhere between 20-50% of the hair. 

And it should be noted that it’s not just the scalp hair that’s affected. You can also have trichorrhexis invaginata affected eyelashes and eyebrows. This could even lead to their complete loss. 

What Causes Trichorrhexis Invaginata? 

As mentioned above, trichorrhexis invaginata occurs as a part of a rare inherited condition, which is autosomal recessive, to be precise. 

So essentially, a faulty gene (named SPINK5) is passed down from each parent to the child, which ends up causing it. 


From that, the formation of certain chemical (disulfide) bonds within the proteins of the cortex (the middle and thickest layer of hair) is affected. 

This, in turn, results in the softening of the cortex and subsequent invagination. 

Since the hair protein keratin is abnormal, it’s unable to have its original strength, making it weak and prone to breakage. 

Can Trichorrhexis Invaginata Be Treated? 

Unfortunately, there’s no standard treatment for it either, but it may include the use of: 

  • Steroids
  • Retinoids (topical and oral acitretin)
  • Calcineurin inhibitors (immunosuppressants)
  • Narrowband ultraviolet B phototherapy
  • Emollients 

One review published in Pediatric Dermatology reported that the use of oral retinoids has been found to make trichorrhexis invaginata better. 

In one of the Case Reports in Pediatrics, an 8-year-old boy was given oral acitretin and a topical moisturiser, and he started showing signs of improvement in 2 months. 

By the 6th month, his hair was reported to have become “longer and stronger.”


In the meantime, you should be very gentle with your hair. Don’t use a lot of heat-styling tools or tie your hair too tightly. It’s also important to have a healthy diet. 

Is Trichorrhexis Invaginata Reversible? 

Since trichorrhexis invaginata occurs as a part of a genetic mutation that doesn’t have a cure, you’ll have this condition for a lifetime. 

But as mentioned above, it may be possible for you to better manage it with the help of various treatments. 

For this, make sure to consult a board-certified medical professional. 


Trichorrhexis invaginata is the result of a faulty gene that ends up affecting the structure of the hair shaft. This ends up making the hair fine, weak, and short. The overall density is also poor, and keep in mind that it doesn’t just affect the scalp. 

Dealing with this defect can, of course, be quite difficult. There is not a lot of research on the treatment of this type of hair shaft defect either. Unfortunately, a hair transplant might not be possible either because of a weak donor area

But if you’re experiencing hair loss, you must consult a doctor for an accurate diagnosis first. They’ll prepare a treatment plan for you accordingly. 

Reviewed and Approved by Dr. Cagla Yuksel.

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