Persistent Hair Breakage: What the Clinician Can Examine

If you have changed how you handle your hair and it still keeps snapping, another product recommendation may leave you frustrated. Ask for an assessment of what is breaking and whether anything else needs checking.

Before the visit: bring the pattern and the history

Trichorrhexis nodosa is a hair problem in which weak or thickened points along the shaft allow hair to break easily. It can be inherited or triggered by practices such as blow-drying, ironing, over-brushing and chemical treatments. Sometimes an underlying condition contributes.¹

That description does not diagnose your breakage. Note when it began, whether it affects one area or several, and what changed before it started. Bring the names of products and the dates of any chemical services you can remember. Include whether this has been a longstanding pattern.

If you have photographs showing the change, take them to the visit. Explain what is bothering you most: loss of length, an uneven appearance or something else.

During the visit: examining the hair itself

The provider examines the hair and scalp. Some hairs may be examined under a microscope or with a specialist magnifier. Blood tests may be ordered for anemia, thyroid disease or other conditions.¹

Ask what the examination shows and whether the clinician has identified trichorrhexis nodosa or is still considering other explanations. If tests are recommended, ask what each one is intended to clarify and how you will receive the result.

After assessment: a plan for the identified cause

When an underlying disorder is responsible, it is treated if possible. Care may also involve reducing physical and chemical damage, gentle shampoo and conditioner, and avoiding prolonged very hot drying or hair ironing.¹

Get instructions that fit your usual styling routine. Ask which practices to change first and when the clinician wants to review whether the plan is helping. Explain any advice you cannot follow so it can be discussed.

DermNet² notes that avoiding a causative exposure may improve acquired structural hair disorders. Ask how that applies to the findings from your examination and what improvement to look for.²

Keep the instructions with your observations

Hair, Everywhere includes a monthly Hair Log and a gentle-styling checklist. Use them to organize observations and discuss your routine alongside the clinician’s instructions. See the book.