The mystery of green hair

ARTICLE

Auteur(s) : Torsten Hinz, Karin Klingmüller, Thomas Bieber, Monika-H Schmid-Wendtner

Department of Dermatology and Allergology, University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany

A 60-year-old grey-haired man reported the development of green tinted hair over a couple of months. The discoloration was patchy and most noticeable in the frontal area (figures 1A, B). He shampooed his hair daily, early in the morning, and denied using anything but shampoo on his scalp. He had no exposure to copper salts at work. The other family members who lived in his household were dark-haired and unaffected. A thorough patient history revealed that the hair discoloration developed after the installation of a decalcification system in the patient’s home where old copper pipes were used. We speculated that a previous mechanical hair alteration (due to daily washing) in combination with the grey hair, together with an increased copper concentration from domestic tap water, led to the formation of insoluble copper deposits in the external hair sheath. Our diagnosis was supported by the successful treatment with a penicillamine-containing shampoo (300-mg capsule dissolved in 6 mL of water and 6 mL of shampoo). His hair recovered its original colour within a few days of therapy (figures 1C, D).

Green hair, also called chlorotrichosis, is a very rare and unusual hair disorder. In most cases, the discoloration is caused by exogenous copper from increased concentrations of copper in taps or swimming pool water. This phenomenon was first reported among copper workers in the 17^th century [1]. There are single reports of green hair pointing to a connection between hair discoloration and contact with nickel, chrome or cobalt, use of tar shampoos or topical treatment of a tinea capitis with yellow mercuric acid [2].

Green hair is usually found in blond (natural or tinted), gray or white haired subjects, most commonly as a consequence of long-term exposure to copper salts in tap water, due to leaching of copper from pipes or in swimming pools, due to copper-containing algicides [3]. In our patient, a lowered pH caused by the decalcification system led to the release of copper from household piping.

The pigmentary change is the result of copper ions being assimilated into the hair matrix. Ultrastructurally and by X-ray examination, the metal can be found in the outer hair sheath, but not in the inner parts. Green hair due to exogenous copper may be associated with prior damage to the hair cuticle resulting from physical (brushing, hot air drying, sun exposure) or chemical (peroxide bleaching, hair dye, exposure to chlorinated water, frequent permanent waving, use of alkaline shampoo) origin [4]. Usually, the superficial strands of the hair are most tinted because these parts show increased mechanical and solar damage, resulting in an increased absorption of copper. In our case, the treatment with a penicillamine containing shampoo was very easy and successful [5]. Further therapeutic options include hot vegetable oil, hydrogen peroxide and (EDTA)-containing shampoo [6]. Although there are no documented case reports in the literature, we would like to point out that a variety of homespun remedies are supposed to be successful in the treatment of green hair, e.g. the application of lemon juice. The citric acid in the lemon juice might work as a complexing agent which removes the copper ions from the external hair sheath.

Acknowledgements

References

2 Sticherling M, Christophers E. Why hair turns green. Acta Derm Venerol (Stockh) 1993; 73: 321-2.

3 Biel K, Kretzschmar L, Müller C, Metze D, Traupe H. Grüne Haare durch häufiges Poolbaden. Hautarzt 1997; 48: 568-71.

4 Petzoldt D, Braun-Falco M. Green hair. Hautarzt 1995; 46: 276.

5 Person JR. Green hair: treatment with a penicillamine shampoo. Arch Dermatol 1985; 121: 717-8.

6 Tosti A, Mattioli D, Misciali C. Green hair caused by copper present in cosmetic plant extracts. Dermatologica 1991; 182: 204-5.