Hair poliosis is a rare condition that you can be born with or develop suddenly, alongside other health disorders. It produces a discoloured patch of hair, which may be permanent or may resolve once the underlying condition is treated [1].
Poliosis is usually nothing to be concerned about (it doesn’t cause hair loss, for one thing) but it can sometimes be a symptom of a more serious disease. That is why it is a good idea to get your white hair streak diagnosed by a dermatologist or trichologist if you’ve developed it later in life rather than at birth. This article will tell you all you need to know about this condition, such as:
Poliosis is defined as a depigmented (white or discoloured) patch in an area surrounded by normally coloured hair. It can occur on any area of the body that contains hair follicles, such as the scalp, eyebrows, eyelashes, beard or chest [1]. However, it is most frequently found in the frontal area of the scalp, which is why it is commonly known as a white forelock or a Mallen Streak (from the book and TV show character Thomas Mallen, who had poliosis) [2].
This condition can affect anyone, regardless of age, gender, or ethnicity. When genetically inherited, poliosis is present from birth and becomes visible as soon as the baby’s hair starts to grow.
People with autoimmune disorders, such as alopecia areata or vitiligo, are more predisposed to this condition. Poliosis may develop when the cells that pigment your hair are destroyed by an inflammatory or autoimmune response [1][3].
There are two types of hair poliosis: genetic and acquired. Here are the main conditions that can cause each of them.
Genetic poliosis is uncommon. Several rare, inherited disorders and syndromes can manifest with hair poliosis, including [1][2]:
If you didn’t always have poliosis but developed it at some point in life, it may be due to one of the following acquired causes [1][2]:
There is only one symptom of hair poliosis: a white or discoloured patch of hair in an area of regular-coloured hair growth.
This streak is often at the front of the scalp, but it can appear in other areas as well, depending on its causes. Any other symptoms experienced alongside hair poliosis are likely to be caused by the underlying condition that has triggered hair discolouration.
Medical professionals can easily recognise poliosis by the tell-tale white or discoloured patch of hair on your scalp, face or body. The challenge is to determine the cause.
Your doctor will ask for your medical history, as well as that of your close biological relatives, to determine if the condition is genetic or acquired [1]. If it is genetic, they will ask about any other accompanying symptoms, to identify its nature.
If your condition is acquired, they will carefully check the affected area for lesions, infections, skin discolouration or signs of immune activity that may accompany poliosis. They will map these findings to any additional symptoms you have described. Once they suspect a certain condition, they may order lab tests to confirm their theory and provide a final diagnosis.
At this time, there is no known treatment for genetic hair poliosis, but there are cosmetic options to mask it (you can dye or cover your white forelock if you want to). However, if your poliosis is acquired, it will often regrow in your natural hair colour after the underlying cause has been resolved [3].
For example, one study published in 2013 revealed that 1-2 months of phototherapy led to the re-colouring of hair follicles in patients with vitiligo-induced poliosis. However, their vitiligo had also been treated and it took 4-11 months for their hair colour to return [16].
A different study reported 75% repigmentation of vitiligo-related eyebrow poliosis after 44 sessions of laser therapy and topical steroid treatment over 6 months [17].
When it comes to other autoimmune conditions, such as alopecia areata, repigmentation may occur after treatments that reduce inflammation in the affected area. Scientists are also testing new treatments that can stimulate hair repigmentation under inflammatory conditions. And if the poliosis accompanies benign or cancerous tumours or lesions, it will normally resolve a few months after these are removed [3].
If you have always had poliosis, it is likely genetically inherited and will stay with you forever (or until you decide to dye it). However, if it is acquired, depending on its underlying cause, it may resolve over time. For example, if it accompanies alopecia areata, your hair colour may revert to normal a few months after going into remission.
Poliosis caused by other underlying conditions can also resolve after treatment. Or, if it was caused by medication, it can subside a few months after stopping treatment [1].
However, hair that is already white cannot regain its colour. It is only new hair growth that can grow in with pigmentation. So a few months after the cause of poliosis is resolved, you may see your hair start to come in coloured once more at the roots, leading to strands that are white at the tips and darker at the base. In most cases, you may need to wait for the strands in your Mallen streak to shed before all traces of poliosis disappear from your hair. Alternatively, trim your hair short when you see its roots regain colour to speed up the process.
No, hair poliosis does not cause hair loss. The only cells in your hair anatomy affected by this condition are the melanocytes in your hair bulb which produce hair colour.
In some conditions, such as alopecia areata, poliosis can accompany hair loss or hair regrowth, but it’s not the reason your hair is falling out. If you are experiencing excessive hair shedding alongside your Mallen streak, it is best to see a trichologist to rule out other frequent hair loss conditions, such as androgenetic alopecia.
Poliosis is not normally a cause of concern if you’ve had it since birth. However, in some rare cases, acquired forms can indicate a potentially serious underlying condition. For example, some forms of skin cancer (melanoma) can be accompanied by hair poliosis around the cancerous lesion [18][19].
Since the scalp is one of the least frequently screened for skin cancer parts of the body, getting newly developed poliosis examined by a dermatologist can lead to a timely diagnosis that increases the chances of treatment success.
If you suddenly develop poliosis anywhere on your body, it’s best to get a professional diagnosis. Book a consultation today with one of our experienced trichologists and they will examine your hair to determine the cause of your condition.
Once they have made their diagnosis, they will provide you with all the necessary insight and advice so you can access the best care and treatment, depending on the underlying condition.
If you still have unanswered questions about hair poliosis, you may find the information you need among the answers to the following common queries.
Stress and anxiety may cause hair loss, but they aren’t known to trigger poliosis. However, there have been some recorded cases where psychological trauma caused people’s hair to turn white overnight. This is known as Marie Antoinette syndrome and it is similar to hair poliosis, but not the same condition, as it involves the entire scalp [20].
No, hair poliosis is not likely to evolve into premature greying. While you may start to grey on certain parts of your hair (e.g. your temples), grey hair due to ageing is normally more diffuse and happens over time. Hair poliosis affects a contained patch of hair (either since birth or with sudden onset) and doesn’t usually grow or spread.
Once poliosis has set in, it doesn’t normally advance over time. However, in certain conditions, such as alopecia areata, it can resolve on one part of the head and appear on another, giving the impression that it is moving or progressing. This is known as migratory poliosis [8].
Yes, you can dye your white forelock just like you would any other patch of white hair. However, unless you’ve had it from birth, it is a good idea to have it looked at by a trichologist or a dermatologist before dying it. They can rule out underlying health conditions that can put you at risk.
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