Acute Hair Matting: Causes, Clinical Features, Treatment

Hair matting is a disorder of the hair shaft, which leads to an entangled and sticky mass of hair.⁽¹⁾ Hair matting is also known as Plica Polonica or Plica Neuropathica.⁽²⁾

Hair matting is most commonly seen in women with long curly hair and the condition is seen occurring more frequently in people who are hysterical or mentally challenged.⁽²⁾

The hair gets matted when they are not being combed and the loose hair gets entangled several times around the strands creating knots. In damaged hair, the cuticles are lifted giving hair a rough texture. Such hair fails to smoothly glide and pass the other strands during combing or brushing.

There are various factors, such as physical, chemical, and behavioural, which can lead to acute hair matting and include:

• Neglected hair care routine.⁽²⁾
• Not detangling hair properly.
• Poor hair hygiene.⁽²⁾
• Using harsh shampoo and chemical on hair.
• Scalp conditions, such as irritant contact dermatitis.
• Impetigo.
• Excessive rubbing of hair.⁽²⁾
• Poor mental health.⁽²⁾

Typical symptoms shown by matted hair are:

• Irregularly tangled and twisted hair.
• Foul smell from the hair.
• Hard, impenetrable keratin mass.
• Hair cemented together with pus, blood, crusts and dirt.⁽²⁾
• Inflamed scalp.
• Infestation of nits and lice on the hair.⁽²⁾
• Painful and swollen occipital lymph nodes.⁽²⁾
• Diffuse non-scarring alopecia.⁽²⁾

Acute hair matting is diagnosed by the appearance and in some cases; trichoscopy may be used to detect small knots, twisted hair, lice and nits in hair.⁽²⁾

Treating acute hair matting is actually quite difficult. In psychological disturbed cases, the patient becomes aggressive during the acute hair matting treatment and patients with religious belief completely deny from getting treated for acute hair matting. The following are the treatment options for acute hair matting:

Using a Solvent or Cutting the Matted Hair: In the early stages of acute hair matting, the twisted hair can be manually separated by using an organic solvent or by cutting off the matted hair.

Medicine for Lice Infestation: In the case of lice infestation, 1% permethrin lotion can be applied to treat acute hair matting. Broad spectrum antibiotic can be given in case of infection of the scalp.⁽²⁾

Washing or Shaving of Hair: A thorough shampoo wash and even shaving off the entire scalp if necessary can be done for treating acute hair matting.⁽²⁾ It is mostly done in severe hair matting cases.

• Matting of the hair can be prevented by taking proper hair care measures.
• Routinely cleaning hair with mild cleanser or shampoo.⁽²⁾
• Regularly using hair conditioner.⁽²⁾
• Periodic trimming of long hair.⁽²⁾
• Gentle combing or moisturizing hair.⁽²⁾

If you love long hair, be sure to maintain them and follow a good hair care regimen. As long hair have a tendency to hair matting, make sure you keep your hair well trimmed, avoid piling your hair on top of the crown while washing, backcombing them, and also avoid rubbing of hair in rotator motion.

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