Trichotillomania and White Hairs: Can white hairs be permanent?

Development of Permanent White Hairs from Plucking

The process by which a hair gets its pigment is very complex. Melanin needs to be transferred from the melanocytes into the developing hair follicle in the anagen phase. A variety of genetic and inflammatory processes can disrupt this process. The autoimmune disease alopecia areata is a classic example of a condition that causes white hairs to grow.

The development of white hairs is seen in patients who pull their hair. This includes trichotillomania and hair pulling conditions along this spectrum. Any white hairs that are produced typically grow back with color. However, extensive damage to the hair follicle apparatus has the potential to cause the hair to lose its ability to properly pigment hairs.

In 2010, Tan and colleagues published a study in the Journal of Cutaneous Medicine and Surgery where they reported an adolescent who developed permanent white hairs after repetitive plucking. This paper is a nice reminder of how delicate the hair follicle machinery is and how, in some cases, extensive damage to the hair follicle may impair the ability of the hair to properly pigment hairs in the future.

Reference

Permanent poliosis following repetitive plucking in an adolescent.

Tan C, et al. J Cutan Med Surg. 2010 Jul-Aug.