Just by examining the hair, dermatologists and other clinicians may find physical evidence of an eating disorder. Characteristic hair features seen on physical examination in anorexia nervosa and bulimia include hypertrichosis, telogen effluvium, hair weathering and fragility, and hypopigmentation. Many of these changes are reversible upon gaining weight appropriately and maintaining a healthy diet with a sufficient amount of protein and calories. Trichotillomania has also been described in association with eating disorders. Hirsutism and androgenetic alopecia are associated with obesity and may also be associated with metabolic syndrome. Unfortunately, hirsutism and androgenetic alopecia may be complicated conditions and require a more extensive workup to properly diagnose and find the true underlying cause. Based on hair changes and physical examination, if a clinician suspects a diagnosis of an eating disorder, appropriate referral and treatment are indicated.
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