Overview
Hypertrichosis, commonly referred to as werewolf syndrome, is an unusual condition characterized by excessive hair growth on various parts of the body, affecting individuals regardless of gender, age, or ethnicity. While this condition is quite rare, it can manifest at birth as a hereditary trait or develop later in life. Since its identification in the 15th century, there have been only a limited number of documented cases of hypertrichosis. This article aims to provide a clear and concise exploration of this hair growth disorder, delving into its origins, causes, classifications, and available treatment options.
What is Hypertrichosis?
Hypertrichosis is a medical condition marked by abnormal hair growth that can occur on specific areas or throughout the entire body. This condition is distinct from typical hair growth patterns influenced by androgens, such as pubic hair and underarm hair, and should not be confused with hirsutism, which predominantly affects women and presents as excessive hair growth in locations typically seen in men, like the face and chest. Hypertrichosis can manifest in individuals of all ages and genders and may be present at birth (congenital) or develop later in life (acquired). Research indicates that a gene mutation may be responsible for this condition, leading to hair growth that exceeds normal levels. In severe cases, individuals may experience total body hair coverage, which can result in numerous emotional and social challenges, including skin irritation, depression, isolation, and stigmatization. Consequently, those diagnosed with werewolf syndrome may face significant impacts on their social lives and personal relationships.
Globally, fewer than 100 cases of werewolf syndrome have been reported since its first documentation by Petrus Gonsalvus in 1642. Importantly, hypertrichosis is neither contagious nor a viral infection, meaning it does not pose a risk to public health. Despite this, individuals with the syndrome are encouraged to seek medical and social support to navigate their conditions and lead fulfilling lives.
The Symptoms of Hypertrichosis
The hallmark of hypertrichosis is the presence of excessive hair growth in atypical areas or across the body, classified into three distinct types:
Lanugo
Lanugo refers to the fine, soft hair covering that infants have at birth. Typically colorless and transient, lanugo should disappear within a few weeks post-delivery. However, if this fine hair persists longer than anticipated, it may indicate hypertrichosis as the child matures.
Vellus
Vellus hair consists of fine, soft follicles that may or may not be pigmented. In cases of hypertrichosis, vellus hair may become more pronounced and visible on all body areas except regions lacking hair follicles.
Terminal
Terminal hair is characterized by its coarse, long, and dark nature, commonly found on the face, underarms, back, and chest of individuals affected by hypertrichosis.
Types of Hypertrichosis
The classification of hypertrichosis is generally divided based on whether hair growth is generalized (affecting the entire body) or localized (confined to specific areas). The two primary classifications are:
Congenital Hypertrichosis
This type of hypertrichosis is present from birth, where excessive hair growth in specific areas does not diminish as expected over time.
Types of Congenital Hypertrichosis
Congenital Hypertrichosis Lanuginosa:
This condition is marked by the persistent presence of lanugo beyond the typical timeframe, continuing to develop as the child grows unless treated.
Congenital Hypertrichosis Terminalis:
Characterized by the emergence of unusually thick, dark, and long hair after birth, this condition can progressively cover the individual throughout their life.
Nevoid Hypertrichosis
Nevoid hypertrichosis presents with localized areas of dense hair growth, which can be managed effectively if the underlying cause is identified early.
Hirsutism
Often confused with hypertrichosis, hirsutism primarily affects women and is induced by hormonal imbalances, resulting in abnormal hair growth in areas typical for men, such as the chin, chest, and back.
Acquired Hypertrichosis
This form of hypertrichosis develops later in life and can present as either generalized or localized hair growth, encompassing lanugo, terminal, or vellus hair types, similar to congenital hypertrichosis.
Causes of Hypertrichosis
Although the exact causes of hypertrichosis remain elusive, researchers have proposed various theories. Congenital hypertrichosis may arise from genetic predispositions, where hair growth genes become reactivated during fetal development, particularly when there is a family history of the condition.
Unlike congenital hypertrichosis, acquired hypertrichosis may result from several factors, including hormonal changes, certain medications, or underlying medical conditions.
Diagnosis
Currently, there is no definitive cure for hypertrichosis; management focuses on controlling and mitigating excessive hair growth. Accurate diagnosis by a healthcare professional is crucial to determine the type and cause of hypertrichosis. Dermatologists may utilize microscopic analysis to assess hair characteristics indicative of hypertrichosis.
For cases of hirsutism, blood tests might be conducted to check for hormonal imbalances, while genetic testing can help identify mutations associated with syndromes like Cornelia de Lange and Rubinstein-Taybi. Imaging tests such as ultrasounds may be employed if cancer is suspected as an underlying cause.
Treatments
Approaches to managing hypertrichosis vary depending on the individual's specific diagnosis and needs.
Avoiding Hypertrichosis-Causative Medications
Minimizing or discontinuing the use of certain medications known to exacerbate hypertrichosis, such as Minoxidil, may help curb excessive hair growth in patients with acquired hypertrichosis. Consultation with a healthcare provider is essential for proper guidance in this regard.
Short-term Hair Removal
Individuals may consider temporary hair removal techniques such as shaving, waxing, plucking, bleaching, or using chemical depilatories to manage hypertrichosis. While effective in the short term, these methods require frequent repetition and may cause skin irritation. Professional assistance from a dermatologist is highly recommended for optimal results.
Long-term Hair Removal Solutions
For long-lasting results, treatments such as laser hair removal, electrolysis, and intense pulsed light (IPL) therapy are available. Laser hair removal targets and eliminates individual hair follicles effectively,
