The syndrome is more common in females than in males. Parents often report that the child's hair is thinning and that haircuts are never needed or are needed only very infrequently. Parents also may have noticed that hair traction, either accidental during playing or intentional, yields clumps of painlessly removed hair. Many parents also complain that hair is unmanageable, lusterless, dry, dull, or matted. Parents or siblings occasionally have a history of similar symptoms.
Affected children are healthy and free from underlying nutritional deficiencies or other illnesses.
Growth and development are normal. Hair may be of varying lengths and may have an unkempt, lackluster appearance. No scalp inflammation or scarring is present. Eyebrows, eyelashes, and body hair rarely are involved. Inheritance appears to be in an autosomal dominant pattern with variable penetrance.