"Bubble hair," a report of two cases.

Dermatopathology Laboratory Monroe, Michigan.

Case 1

A 20-year-old woman presented with a patchy area of hair loss in the occipital scalp area.

The patient's hair care included the use of a blow dryer. Microscopic evaluation of a gentle hair pull revealed vacuolization of the hair shafts.

The hair shafts were enlarged in the areas of vacuolization. There was no evidence of dermatophyte hyphae on examination with KOH technique.

A diagnosis of bubble hair was made.

The patient's alopecia improved with gentle hair care and discontinuation of blow drying.

At 1-year follow-up, there was no evidence of residual alopecia.

Case 2

A 42-year-old woman presented with diffuse hair loss and increased hair fragility

The patient had a history of blow drying her hair with the heat set on the "high" setting on a daily basis. She also reported holding the blow dryer close to her scalp.

Examination of her hair shafts revealed multiple areas of vacuolization of the hair shafts 

Examination with KOH technique showed no evidence of dermatophyte hyphae.

The patient was instructed to discontinue the use of high heat in her hair care regimen.

At 1-year follow-up, the patient's alopecia had improved.