ANATOMY OF HAIR

Dr Navreet Sekhon

JR 1

Dept of Drmatology
• Hair is a derivative of the epidermis and consists of two distinct parts:
a) the follicle
b) hair shaft
• made of a tough protein called keratin.
• Anchored to skin by Hair Follicle.
• Base of hair follicle is Hair Bulb.
• cells divide in hair bulb to form Hair shaft.
COMPOSITION OF HAIR :
a) 65-95% proteins
b) 32% Water, Lipids
80% of protein component is keratin with a high grade of sulfur containing
amino acid, Cystine.
FUNCTIONS OF HAIR
1)
2)
Thermoregulation
3)
4)
Physical barrier against heat and UV radiation
5)
6)
Regeneration and repair of epidermal and dermal tissues
7)
8)
Secondary sexual characteristics
9)
10)
Sensory organs : HFs have mechanoreceptors
11) Medicolegal value : Specimens found at crime scenes and forensic
toxicology
PILOSEBACEOUS UNIT :
1) Arrector pili muscle
2) Sebaceous Gland
3) Hair follicle
Racial variation is observed in the cross section of HFs
a) round : mongoloids
b) oval : Caucasians, Americans, Europeans and middle
Eastern population
c) Flat hairs with dense and clumped pigmentation: African
 HAIR FOLLICLE
Neuroectodermal- mesodermal origin
essential unit for the generation of hair.
A bidirectional communication is present between
ectoderm and mesoderm – creating an internal mileu
for an independent survival.
autonomous tissue
Reservoir of stem cells
pluripotent and self regenerating
Undergo continuous cycling throughout adult life
Therefore have the ability to grow at transplanted sites
FOLLICLE DENSITY :
No. of hair follicles per unit area
Fetus has the highest HF density
In Adults : Highest HF density seen at
Forehead : 800/ cm2
Cheeks : 400-450/cm2
•Scalp : 100,000 HFs
RATE OF HAIR GROWTH
• Human hair grows at a rate of 1cm/month or 0.35 mm/day
FOLLICULAR MORPHOGENESIS

During embryonic development, HFs appear at about 8 weeks in the

regions of eyebrows, upper lip, chin
Entire body covered by 4th month
Initial hair population completes its cycle by 22 weeks
New hair follicles are never formed postnatally
At time of birth, it is estimated that around 5 million HFs are present
3 PROCESSES OF FM :
1) Induction : hair placode is formed
2)

3) Organogenesis : Hair peg is created

4)

5) Cytodifferentiation : Bulbous hair peg is formed

 4 stages of FM :
A) PRE - GERM STAGE :
Thickening of the overlaying basement membrane
Aggregation of mesenchymal cells in the superficial dermis
forms the location of new HF
B) GERM STAGE :
Formation of “hair germ”by downward elongation of basal epidermal cells
Replication of mesenchymal cells which form rudimentary dermal papilla
C) HAIR PEG STAGE :
The epithelial cells grow downwards forming a column or hair peg
propels the aggregate of mesenchyme downwards
D) BULBOUS PEG STAGE :
In hair peg colum, 3 areas of swelling appear-
1) uppermost swelling : Apocrine Gland
2)

3) Middle swelling : Sebaceous Gland

4)

5) Lowermost : Prospective site of attachment of arrector pili

E) PRIMORDIAL HAIR STAGE :
a) The basal cells surrounding DP actively proliferate
b)

c) Forming first primordial hair shaft, which tends to move-upwards

d)

e) The central cells in the follicular PEG show degenerative changes,

emerging hair pushes the plug out , forming hair canal
CLINICAL CORRELATION – ANDROGENIC
ALOPECIA
•Arrector pilorum firmly attaches to one follicle in the FU
known as primary follicle
• This primary follicle is least susceptible to the effects of
androgen
• Secondary follicles which have loose anchorage, miniaturize first and cause
loss of anchorage of arrector pilorum muscle
• when the arrector pilorum muscle detaches, primary follicles also undergo
miniaturization
STRUCTURE OF HAIR broadly divided into
a) Hair shaft
b)

c) Hair root
Hair Root is anatomically divided
into 4 parts from below upward
1) The bulb : comprising of DP and
matrix
2)

3) The suprabulbar area : From matrix

to insertion of arrector pili muscle
4)

5) The isthmus : From insertion of

arrector pili muscle to the opening of
sebaceous gland duct
6)

7) The infundibulum : Sebaceous duct

opening to the follicular orifice
CROSS SECTION OF HAIR FOLLICLE AT
BULBAR REGION
•From outside to inside :
a) ORS (trichilemma)
b) Henleys layer of inner sheath

c) Huxleys layer of inner sheath

d) Cuticle of inner sheath

e) Cuticle of hair
f) Cortex of hair
g) Medulla of hair
THE DERMAL PAPILLA
•Present at the base of HF
derived from mesenchymal cells
Made up of specialised fibroblast like cells
Continuous with the dermal sheath surrounding
the follicle
Contains a loop of capillary blood vessels
Source of hair : the active germinal epithelium
lying over the DP
PHENOMENON OF INDUCTION :
The response of one cell population to the signals
from a second population.
The close proximity of DP to GM induces it to
proliferate by releasing chemical signals
 DP is androgen responsive as it expresses androgen receptor ( 5 alpha
reductase type 2)
HF epithelium expresses only 5 apha reductase type 1
DP in different stages of hair cycle :
a) Anagen : well developed
b) Catagen : shrinks and withdraws away from bulb

c) Telogen : much smaller

Functions :
1. Induction and maintenance of follicular epithelial differentiation
2. determining the follicle type and size
SUPRABULBAR REGION
Longest part of terminal HF
Max length in Anagen phase
Made of 3 layers from inside-out :
a)
b)
Hair Shaft
c)
d)
Inner root sheath (IRS)
e) Outer root sheath (ORS) :
I. multilayered enclosing IRS (fully keratinised)
II. Filled with glycogen in anagen phase (pale and clear cells)
III. Forms a bulge between arrector pilorum muscle insertion and sebaceous gland
ISTHMUS
Extends from the insertion Arrector Pili
muscle to opening of sebaceous gland duct
Principal feature : multilayered ORS
Innermost cells of ORS : trichilemmal
keratinization
(trans differentiation of stratified squamous
epithelium into non nucleated keratinized cells
containing compact eosinophilic keratin)
Keratinized IRS ( within ORS) disintegrates
Bulge below isthmus : harbors stem cells
INFUNDIBULUM
Similar to epidermis but lacks rete ridges
Epithelium arranged in basket-weave pattern
Contains a granular zone with numerous
keratohyalin granules
Follicular infundibula are a nidus for non
pathogenic commensals and a variety of bacteria
(Staph Epidermidis, Cutibacterium acne)
Infundibular cyst and Infundibular carcinoma has
been reported
 HAIR SHAFT
Made of 3 cell layers :
a. Outer cuticle
b.

c. Middle cortex
d.

e. Central medulla
THE CUTICLE
Outermost layer of hair
Has 5-10 overlapping layers and contain transparent cells devoid of
melanin
Formed initially as a single cell layer, as they move peripherally
they become imbricated and flattened
 Mature cells of cuticle show 3 distinct layers
i. Outer A layer , rich in cysteine
ii.

iii. The exocuticle ( also rich in Cysteine) has 3 parts

The b- layer
The a- layer
Epicuticle – hydrophobic lipid layer of 18-
methyleicosanoic acid on the surface of fibre or (f
–layer)
iii.Inner endocuticle
 In poor hair grooming practices (bleaching, perming) f-layer damaged and
removed which causes hair weathering
Function of Cuticle :
a) Provide lustre
b) Elasticity
c) Resilience
d) Texture of shaft
e) Barrier against chemical insults
f) Water resistant and controls water content of the fibre
THE CORTEX
a) Forms middle layer
b)

c) Constitutes 90% of hair’s weight

d)

e) Hydrophilic
f)

g) Compactly arranged spindle cells

h)

i) Rich in intermediate keratin filaments which are parallel to the long axis of
hair shaft
j)

k) The keratin chains have high cysteine residues in adjacent keratin filaments
which form covalent disulphide bonds
THE HAIR BULB
•Lowest part of hair enclosing the DP.
Bulb can be divided into two zones :
a) A lower region of undifferentiated cells
b) An upper region of differentiated cells

Auber’s line : A line seperating these two zones

at the critical level, the widest portion of papilla
 The upper region further subdivided into :
a) Pre-elongation region :
above the critical level in the widest portion of bulb
cells align vertically
trichohyalin granules absent
b) cellular elongation region :
• cells are elongated
• with narrow diameter
c) Cortical pre keratinization region :
•basic dye-stainable fine fibrils seen (pro-keratin material)
d) Keratogenous region :
•well formed stabilized keratin
•Nucleated hyalinized epithelial cells
ADAMSON’S FRINGE
•located at the upper margin of the
keratogenous zone of the hair follicle
where the nucleated hair shaft cornifies
completely and gets converted to hard
anucleated keratin.
HAIR BULB MATRIX /
GERMINAL EPITHELIUM
•Epithelial cells surrounding the DP
•high mitotic rate and cell turnover
•cells migrate upwards and differentiate
to form concentric layers of IRS and
hair shaft
• occasionally Langerhans cells seen
TYPES OF HAIR
Different types of hair are formed on human body under the influence of
a) molecular mediators
b) hormones
c) Advancing age
Broadly, there are 4 different types of hairs :
1) Lanugo Hairs

Fine, soft, unmedullated and often unpigmented prenatal hair which covers the entire body
in utero and is shed by 8th- 9th month of gestation
Replaced by vellus hairs by 36-40 weeks
Therefore, its presence may indicate prematurity
A ) Congenital Hypertrichosis Lanuginosa
the fetal pelage of vellus hair persist and grow excessively with renewal
throughout life
B) Hypertrichosis Lanuginosa Acquisita
• Rapid growth of lanugo hair around the eyebrows , forehead, ears and nose
Seen with aerodigestive tract malignancy
Also reported in anorexia nervosa, bulimia nervosa : In an attempt to
prevent heat loss from the body owing to loss of subcutaneous fat
Postnatal hair divided into three kinds :
a) Vellus
b)

c) Terminal
d)

e) Intermediate hairs
A) VELLUS HAIRS
• soft, unmedullated and occasionally pigmented
• present all over the body except on the lips, back of ear,
palm of hand, sole of foot, umblicus, some areas of external genitalia and scar
tissue
After puberty, replaced by “terminal hairs” in androgen dependent areas (beard,
axilla pubic area)
Help in preventing loss of heat from the body
These are resistant to laser hair reduction
Eruptive vellus hair cyst : Developmental anomaly of vellus hair leads to
monomorphic eruption on the chest, limbs and abdomen
B) TERMINAL HAIRS
Coarse pigmented long hair which possesses a medulla
Normally limited to eyebrows, eyelashes and scalp till puberty
Later, replace vellus hairs in the beard, axilla, pubic area, etc
Pubic and axillary hair growth - Secondary sex characteristics in both
sexes
Males - terminal hair on face, chest, abdomen, arms and legs
C) INTERMEDIATE HAIRS :
•show characteristics of both vellus hairs and terminal hairs
• They have a medulla and moderate amount of pigment
• seen with the onset of puberty and are androgen responsive
• At puberty, follicular responses to androgens are varied:
a) Unresponsive : Eyelashes, eyebrows, etc
b) Responsive : Scalp hair (temporal region, ant hair line, vertex, mid frontal areas), beard,
Chest hair, axillary, pubic area hairs
- Transform from vellus to terminal during which intermediate hairs are formed.
- During balding, terminal follicles change to intermediate forms and then eventually
miniaturisation causes vellus hairs to develop, resulting in androgenic alopecia.
 Morphological variants of Hair
These are of 4 types :
a)SPIRAL HAIR:
Africans
HFs are curved and the bulb base is oriented horizontal to the skin surface
Different growth rate of matrix cells along the side of bulbs may lead to spiraling
Curly hair impedes UV light penetration into the body relative to straight hair
Therefore, spiral hairs are advantageous for dark skinned humans living at equator .
b) STRAIGHT HAIRS :
Seen in Asians
HFs are straight and oriented vertically to the skin surface
Might have evolved to allow the entry of UV light into the body during the
transition from dark, to pale white skin
c) HELICAL HAIRS :
Seen in whites
Also reported in trichorrhexis invaginata and pili torti in Netherton’s
syndrome
d) WAVY HAIRS :
Tightly coiled hair that occur over the entire scalp or part of it
Non-negroid individuals
 HAIR CYCLE
• Hair development is a continuous cyclic process of growth (anagen),
regression (catagen), rest (telogen) and shedding (exogen) phases.
• The duration of the phases changes based on the location of the hair and also
personal nutritional and hormonal status and age.
• Each strand of hair has a special phase of hair growth.
• New strands of hair form after completion of cycle
• Hair strands grow in three different phases: - Anagen, Catagen, Telogen,
Exogen
ANAGEN
The anagen is the active growth phase in which the follicle enlarges and takes
the original shape and the hair fiber is produced. Almost 85–90% of all scalp
hairs are in anagen.
Hair shaft synthesis and pigmentation only take place in anagen.
The degree of axial symmetry within the hair bulb determines the curvature of
the final hair structure.
• Fiber length is often dependent on the duration of the anagen or actively growing
phase of the follicle.
The anagen hair root is covered by a long sheath.
 EARLY ANAGEN :
a. Progenitor cells show mitotic activity and envelop DP
b. Invaginate downward and differentiate into IRS and Hair shaft
c. DP expand into flask shaped structure
d.

e.

f.

MID ANAGEN :
a. Melanocytes in matrix begin to synthesise melanin, new hair shaft starts
emerging
b. Deposition of proteoglycan rich extracellular matrix and BM proteins
starts in tightly packed DP, causing it to separate
 Cutaneous vasculature plays a major role in Anagen
Keratinocytes of ORS produce VEGF – upregulated- resulting in
formation of a network of capillaries around HF- accelerating hair growth
LATE ANAGEN
a. Complete restoration of hair fibre producing unit
b. Formation of hair bulb surrounding the DP in the subcutaneous tissue
c. New hair shaft emerges from skin surface
SUBSTAGES OF ANAGEN
STAGE 1 – Starts from onset of cell division and DP growth
STAGE 2 – DP gets enveloped circumferential by matricial cells of hair
bulb
STAGE 3 – Matricial cell diff. into follicular components
STAGE 4- Elongation of HF till base of sebaceous gland with matrix
melanocytes reactivation
STAGE 5 – Dislodgement of telogen hair by developing hair shaft
STAGE 6 – Emergence of newly formed hair shaft
CATAGEN
Known as transition phase.
Catagen lasts approximately 2 weeks in humans, regardless of the site
and follicle type
Phase of involution, mitotic activity declines and ceases (passive
process)
the proximal of the hair shaft is keratinized and forms the club hair,
whereas the distal part of the follicle is involuted by apoptosis and
forms a glassy membrane
Scalp hairs grow faster on women than men and slows sharply after
age 50.
Catagen phase is consisted of eight different stages. The first sign of
catagen is the termination of melanogenesis in the hair bulb.
 A dec in growth promoting factors and increase in inhibitory factors (TGF-β, TNF-
Alpha , IL-1 alpha ) trigger Catagen
Regulated by ectodysplasin- signalling pathway
Proto-oncogene BCL-2 ( apoptosis inhibitory) expressed in Anagen
but disappears in catagen
Control of catagen very important, because very early termination
of Anagen leads to Alopecia effluveum
If catagen is delayed , hirusitism and hypertrichosis occur
• Less than 1% of the scalp hair is in the catagen phase at any one time.
TELOGEN
Known as shedding phase
The telogen stage is defined as the duration between the completion of
follicular regression and the onset of the next anagen phase.
DP produce GF BMP -4 which interacts with receptor BMPR-1A expressed by
keratinocytes and causes suppression of follicular growth and differentiation.
• Telogen stage lasts for 2–3 months.
Approximately 10–15% of all hair is in telogen stage.
During the telogen stage, the hair shaft is transformed to club hair and finally shed
through an active process called EXOGEN
EXOGEN hair do not retain ORS unlike plucked telogen hairs