The "V sign" in Trichotillomania

Trichoscopy (Scalp Dermoscopy) of Trichotiillomania: The V sign

Trichotillomania is a hair loss disorder whereby patients pull out their own hair. Underlying depression, anxiety and obsessive compulsive disorder is also present in many patients as well as a range of other psychological conditions. 3-4 % of the world will experience trichotillomania at some point in their lives.

There are several trichoscopic (dermatoscopic) findings in trichotillomanoa including broken hairs, v-sign, flame hairs, hair powder, tulip hairs, and coiled hairs. The most common are the irregularly broken hairs.

The “v sign” represents two hairs that were pulled at the same time and snapped off at the surface. They are found in well over 50 % of patients with trichotillomania.

The V sign in trichotillomania

The following is a typical trichoscopic image of the V sign in a patient with trichotillomania.

The V-sign

Reference

Rakowska et al. New trichoscopy findings in trichotillomania: flame hairs, V-sign, hook hairs, hair powder, tulip hairs. Acta Derm Venereol. 2014