Book Review

Hair Growth and Disorders

N Engl J Med 2009; 360:1050-1051March 5, 2009

Article

Hair Growth and Disorders
Edited by Ulrike Blume-Peytavi, Antonella Tosti, David A. Whiting, and Ralph M. Trüeb. 564 pp., illustrated. Berlin, Springer, 2008. $219. ISBN: 978-3-540-46908-7

Interest in hair biology and clinical trichology has increased during the past 20 years, and there have been considerable advances in our understanding of the biology and treatment of hair and scalp disorders. Hair Growth and Disorders is a comprehensive review of the topic, with an emphasis on follicular structure and function along with the presentation of disease. The book covers the full range of topics from basic principles of hair biology to rare genodermatoses that manifest as hair disorders. The authors and editors have constructed an effective didactic tool that can serve a wide variety of learners, from medical students to practicing clinicians and researchers.

The breadth of this compendium is extensive; its 28 chapters were written by a distinguished roster of internationally recognized experts in the field. The chapters cover three main topic areas — basic aspects of human hair growth, hair and scalp disorders, and photoepilation, surgery, and hair cosmetics. The chapters that are the most well-written and readable follow a common format, beginning with a “key features” box and ending with a summary, both of which confer a cohesiveness to the text. In addition to the table of contents at the beginning of the book, a chapter-specific table of contents is included at the start of each chapter for easy reference.

Readers will appreciate the clinical photographs and the impressive graphics, tables, and histologic illustrations that are included in many chapters. The color clinical photographs that appear in most chapters are a strong point that is lacking in many other books on this topic. With the exception of a few slightly blurry photographs in the chapter on the hair of persons of African descent, as well as some distracting photographic backgrounds, the clinical representations are illustrative of important teaching points. Subsections of some chapters, however, do lack appropriate illustrations. For example, a table with side-by-side schematic drawings comparing the microscopic appearance of each hair shaft abnormality would have been beneficial.

Color-Enhanced Scanning Electron Micrograph of the Split End of a Human Hair, Showing the Outer Cuticle Layer Surrounding the Inner Cortical Layer.

The book's initial chapters, in which hair follicle biology, the hair cycle, histology, and other topics are discussed, give the reader the necessary background to understand the complexity of hair and scalp disorders. Authors of later chapters delve into the common and uncommon hair and scalp disorders physicians may face in clinical practice. The separation of primary and secondary cicatricial alopecias into distinct chapters allows for a more thorough discussion of this topic than is usually presented. Also included is a well-written chapter on alopecia areata, with a large portion of the chapter devoted to pathogenesis. In two of the final chapters of the book, hair cosmetics and the various surgical and laser treatments that are available to treat hair and scalp disorders are reviewed. Although it is interesting, the chapter on the social history of hair and its depiction in art seems out of place between a chapter on hair in forensic medicine and a chapter on natural products for hair care and treatment. These chapters are filled with useful information, whereas the chapter on art and culture is for those who simply love to read about hair (and there are many of us).

Although there is some redundancy of topics, it is hardly avoidable in such a large textbook that is written by numerous authors. The chapter on disorders of the scalp is a nice and surprising inclusion that allows for the discussion of many topics that do not fit into other chapters. However, the treatment regimens that are discussed in the chapter are not uniformly satisfactory — the discussion of the treatment of psoriasis, for example, does not mention the combination drugs that are available for use on the scalp or the role that topical treatments play in patients' compliance.

Alopecias, along with other hair and scalp dermatoses, are a frequent presentation at dermatology clinics. Minor criticisms aside, this book serves its purpose of providing up-to-date information on these topics as well as a good overview of the diagnosis and treatment of patients with various hair and scalp conditions.

Ashley R. Curtis, M.D.
Amy J. McMichael, M.D.
Wake Forest University School of Medicine, Winston-Salem, NC 27157
acurtis@wfubmc.edu