Causes of Poliosis Hair or Mallen Streak Symptoms & Treatments

Unique characteristics can either garner attention or isolate you for being different. Remember Johnny Depp’s character from the movie “Sweeney Todd” or the singer Bonnie Raitt? They both have white streaks of hair, known as poliosis.

Many celebrities born with this condition have gracefully accepted their fate and confidently flaunted their unique hair trait. Ultimately, it comes down to how you embrace your distinctive traits.

This article will explore poliosis circumscripta or mallen streaks in detail, focusing on various causes and symptoms of this condition. We’ll also look into different management options so you can choose the right one for yourself.

What Is Poliosis?

Poliosis is a rare condition where one or more patches of white hair occur while the rest of the hair maintains its natural color. 

It comes from the Greek word ‘pilios’ meaning gray. Naturally, hair gets its color from melanin, a natural substance in the human body. People with poliosis have either decreased levels or complete absence of melanin in the affected hair roots.

What Are The Causes Of Poliosis?

The exact cause of poliosis is not fully understood, however, researchers identified several factors that may play an important role in causing the condition:

Genetic Causes

Inherited defects in the melanin production can lead to white patches of hair. These inherited or genetic defects are passed down from parents to children, leading to the presence of poliosis in newborns or can develop in early life. 

Some rare genetic conditions include:

• Piebaldism: In this condition, the cells called melanocytes responsible for melanin production in the skin and hair are absent.
• Waardenburg Syndrome: This group of genetic conditions can lead to pigmentation changes in hair, skin or eyes, along with other symptoms such as hearing loss or cleft lip.
• Tuberous Sclerosis: Light colored hair can be an early sign of this non-cancerous condition called tuberous sclerosis. This condition can lead to multiple benign tumors in the brain and other areas of the body such as nerves, eyes, skin and spinal cord.
• Vogt-Koyanagi-Harada Syndrome: It is a multisystem autoimmune disorder that can affect pigmentation. It also affects eyes, ears, skin and brain leading to symptoms such as visual disturbance, hearing loss etc.

Acquired Causes

Some external factors can lead to the development of poliosis later in life, resulting in patches of grey hair. Some of these acquired causes are:

• Medications: Some medications, such as antibiotics (chloramphenicol) and anticancer medications (cetuximab), can cause poliosis as a rare side effect.
• Injury: Trauma to the scalp or skin can damage pigment-producing cells located at the base of hair follicles. This includes cuts, burns, severe abrasions or diseases like herpes zoster and radiotherapy.
• Nutritional Deficiencies: Deficiencies in vitamins and nutrients can lead to premature aging and graying of hair. Common deficiencies associated with poliosis include vitamin B12, copper, zinc, selenium and folic acid. Moreover, vitamin D deficiency in teens and children can potentially worsen early greying.
• Environmental Exposure: Stress, pollution, UV radiation, harsh hair chemical treatments, and passive smoking can accelerate premature graying. 
• Dietary habits: Poor dietary choices can harm hair health. Inadequate protein intake and consumption of junk food can cause hypopigmentation and early aging. Certain diet patterns can lead to folate or vitamin B12 deficiency, weakening hair strength and pigmentation.

What Are The Symptoms Of Poliosis?

Poliosis, also known as mallen streak, can occur anywhere on the body. There is no defined pattern or number of white hairs. It could be one or more patches of white hair. Common areas where poliosis can occur include:

• Head (usually called “white forelock”)
• Eyelashes
• Eyebrows

It is important to note that greying hair is different from poliosis. Gray hair is interspersed with normal colored hair, whereas poliosis leads to distinct patches of colorless hair.

How Do You Test For Poliosis?

A distinct patch of white hair is visible to the naked eye and can be diagnosed clinically. But as it is generally related to certain diseases, it’s best to seek professional medical help.

Diagnostic Tests

Depending on your symptoms and medical history, you may have some tests such as:

• Wood’s Lamp Examination: This test helps detect pigments including melanin, in the scalp or skin.
• Blood Tests: Your doctor may prescribe blood tests to check for any nutritional deficiency, thyroid hormone profiles for underlying disorders, or tests like ESR, CRP to check for any inflammatory conditions in the body.
• Skin Biopsy: A small sample of skin tissue is examined under a microscope to look for melanin and pigment producing cells in the hair follicles.

Age As A Clue

The age at which mallen streaks appear can give you a clue regarding coexisting medical conditions.

1. Children or Babies: They may have a genetic or inherited condition. Therefore, the healthcare provider will look for other signs of syndromes.
2. Adults: The presence of mallen streaks in adults can be a sign of autoimmune disease or cancer which needs to be diagnosed as early as possible for better prognosis. Your doctor may ask you about your family history or medical history to get a better idea.

Is There A Treatment For Poliosis?

Since poliosis is not a serious condition, no treatment is necessary. Some people manage it with hair treatments.

1. Hair Dye: A temporary solution to cover white hair.
2. Camouflage: Cover with hats, bandanas, headband or other hair covers.
3. Medicines: Topical or oral medical treatment based on underlying cause and severity of symptoms.
4. Skin Grafting Treatment: For some patients, skin grafting followed by light therapy for a few months, along with regular use of medicine and ointment has been found to be useful. But it is very expensive and intense.

How Can I Make My Child With Poliosis Confident?

Discovering poliosis in your child can be an overwhelming experience. Encourage your child to embrace this condition with positively:

1. Embracing Unique Characteristics: Remind them that their unique feature is a strength and a beautiful trait.
2. Promote Positive Self-Image: Help your child celebrate their individual characteristics by reinforcing and nurturing their self-esteem.
3. Education: Ensure that they understand what poliosis is and how it can be managed to reduce fear or uncertainty.
4. Support & Counselling: If the condition affects their mental well-being, seek professional help for coping strategies and emotional support.

What Are The Other Conditions Associated With Poliosis?

While a patch of grey hair is not harmful, it could indicate underlying medical issues. It’s important to get checked to diagnose any serious conditions.

Frequently Asked Questions

Can a Mallen streak go away?

Mallen streaks usually do not go away, especially if they are genetically inherited. Hair dye is an option to cover it up. However, if it is acquired, treating the underlying condition can help prevent it from recurring.

What celebrities have a Mallen streak?

Some celebrities who are known to have a Mallen streak are:

• Richard Madden (actor)
• Ed Milliband (politician)
• George Lamb (TV presenter)
• Susan Sontag (author)

Can poliosis be caused by stress?

Yes extreme psychological stress can cause poliosis, however, it is not the primary cause. Multiple factors, including genetic and environmental factors play a role.

Is it possible to be born with white hair?

Yes, it is possible to be born with white hair, a condition known as poliosis, caused by the loss of natural hair pigment in a patch of hair.

Are mallen streaks rare?

Yes, mallen streaks or poliosis is a relatively rare condition. Its incidence is estimated between 1 in 40,000 or 1 in 100,00. 

Does poliosis spread to other parts of the head?

Poliosis usually does not spread to other parts of hair once it appears.