Scalp Hair Characteristics in the Newborn Infant

Susan A. Furdon, RNC, MS, NNP; David A. Clark, MD


Adv Neonatal Care. 2003;3(6) 

In This Article

Abstract and Introduction

Scalp hair growth and patterning are closely associated with the development of the central nervous system. A number of genetic, metabolic, and neurologic disorders are associated with recognizable scalp hair abnormalities. For this reason, a systematic step-by-step assessment of the hair and scalp should be an integral part of every initial newborn physical assessment.

This article reviews the clinically relevant embryology related to fetal scalp hair formation. Normal cycles of hair growth and loss are discussed. A systematic review of typical newborn scalp hair characteristics such as color, quantity, texture, direction of growth, hairlines, and hair whorls is provided. Conditions associated with abnormal hair color, quality, quantity, and distribution are presented in a series of clinical photographs, and their salient features are discussed. Abnormal hair often occurs as a constellation of findings; implications for clinical care and further investigation will be briefly described.

Clinical inspection of scalp hair characteristics can provide important clues to aid the early identification of genetic, metabolic, and neurologic disorders.[1–3] A number of autosomal dominant, autosomal recessive, and X-linked single gene disorders are characterized by hair abnormalities.[3] Hair color can also signal a metabolic disorder or nutritional deficiency. Patterns of hair growth can be abnormal, serving as external markers of underlying structural brain and central nervous system abnormalities.[2]

The initial assessment of all newborns should include a systematic assessment of hair color, quantity, texture, direction of growth, hairlines, and hair whorls.[3,4] An understanding of the embryologic development and cycles of scalp hair growth will aid the clinician in assessing infants of various gestational and postnatal ages. Infants with suspected pathology may benefit from a focused reassessment, an in-depth family history, and a careful inventory of atypical or abnormal hair characteristics.


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