In almost all civilizations, the hair bears special importance: it is a synonym of beauty and strength. Having smooth and easy-to-style hair is a constant demand of women and also men. Hair straighteners are highly popular around the world, although they may cause great damage to the hair [1], such as breakage, falling, burns, and eczema [2]. The manifestations of hair breakage caused by straightening may be heterogeneous, ranging from poor hair growth to patchy alopecia. A dermoscopic examination of hairs obtained by a pull test allowed us to diagnose hair breakage in all cases. The hair fragments had no roots, yet rather brush-like tips and swelling along the shaft caused by trichorrhexis nodosa. Central trichoptilosis (longitudinal split in the central part of the shaft) was another common finding [3].

Herein, we report the case of a 34-year-old female patient with no notable pathological history who consulted us for hair loss and pruritus on the scalp three days after the application of a straightening product. On examination, the traction sign was positive in some places, and we also noted erythema on the scalp (Fig. 1) with small vehicles on the frontal edge. A dermoscopic examination revealed an erythematous background with broken, bent hairs on the entirety of the hair (Figs. 2a and 2b). Our patient was administered a shampoo based on corticoids.

	Figure 1: Clinical picture showing erythema on the scalp.
	Figure 2: (a) Dermoscopic picture showing an erythematous background (purple asterisk), with broken, bent hairs on the entirety of the hair (red arrows) at the frontal level. (b) Dermoscopic picture showing an erythematous background (purple asterisk), with broken, bent hairs on the entirety of the hair (red arrows) at the vertex.

REFERENCES

1. Barreto T, Weffort F, Frattini S, Pinto G, Damasco P, Melo D. Straight to the point:What do we know so far on hair straightening?Skin Appendage Disord. 2021;7:265-71.

2. Tennstedt D, Herman A, Lachapelle JM. Adverse effects of hair care in users. Ann Dermatol Venereol. 2018;145:521-31.

3. Quaresma MV, Martinez Velasco MA, Tosti A. Dermoscopic diagnosis of hair breakage caused by styling procedures in patients of African descent. J Am Acad Dermatol. 2015;72(1 Suppl):S39-S40.