PubMed · 629567
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G D Brauner. 1978. Pseudofolliculitis capitis.. https://pubmed.ncbi.nlm.nih.gov/629567/
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The manageability of the hair is dependent on the surface composition of the hair shaft. Exogenously caused damage leads to unmanageability by massive superficial defects in the hair cuticle. The symptoms of trichorrhexis nodosa and trichoptilosis are present, and superficial horny scales are bent up and curve under in tunnel-like fashions. Appropriate hair care can improve these defects. Endogenous damage to the hair leading to unmanageability is characterized by spiral furrows along the shaft. It can not usually be improved by the use of care products. The examples presented in the paper demonstrate that exogenous and endogenous causes of unmanageability are characterized by different alterations in the hair shaft.
The capacity to measure the severity of trichotillomania is necessary for studies of the efficacy of treatment interventions. To date, researchers have used diverse methods, including: the adaptation of instruments designed for other purposes, counting episodes of hair pulling, counting hairs that have been pulled out, and both physician- and self-administered scales of severity or improvement. In this paper, the authors review the methods that have been employed, discuss problems in the measurement of trichotillomania, explore the potential for objective measures of hair loss and introduce a new instrument, the Psychiatric Institute Trichotillomania Scale.