Monday, March 10, 2008


The 68-year-old woman pictured above "requested medical attention for a sudden increase in hair growth that she had noticed 11 months earlier. She had lost more than 30 kg during this same period. Physical examination revealed fine lanugo hair all over her face (Panel A) and body (Panel B) and a deeply furrowed tongue, which caused a burning sensation. A diagnosis of acquired hypertrichosis lanuginosa was made...the woman was depressed about her condition and decided to shave. "

"Hypertrichosis lanuginosa acquisita (HTLA) is excessive growth on the body of fine hair of the lanugo or vellus type...Metabolic conditions reported to be associated with HTLA include...malnutrition, especially when due to anorexia nervosa."

Lanugo, a medical consequence of anorexia nervosa, is often mentioned but seldom discussed, which is surprising, given its horrific psychological impact on its sufferers. The term "lanugo" is from the Latin lanugo down, from lana wool.

Amy Winehouse (note the lanugo on her face)

As mentioned above, lanugo can occur not only on the face but all over the body in an effort to keep the body warm when the body lacks enough fat to accomplish this.

Below is an excellent summary of more of the devastating effects of anorexia nervosa on the body:

"Anorexia causes many physical problems. For instance, it upsets the normal functions of hormones. For girls, this means the body is unable to produce enough of the female hormone estrogen because it does not have enough fat. This will cause an absence of menstrual cycles, called amenorrhea. For boys, anorexia causes a decrease in the production of the male hormone testosterone, which results in a loss of sexual interest.

An anorectic body lacks the protective layer of fat it needs to stay warm. To compensate for the lack of fat, lanugo (fine hair) will grow all over the body to keep it warm. Another problem anorexia causes is a decrease in bone mass. The body needs calcium for strong bones. Since an anorectic is not eating enough food, which is the source of calcium, the body's bones suffer and weaken. Later in life, this could result in a dangerous bone disease called osteoporosis.

Additionally, without the fuel it needs, an anorectic's body will respond as if it is being assaulted and begins to fight back in order to survive. To survive the body must have energy, but because the body has no food to turn into energy, it seeks out the muscles, and eventually, the organs (heart, kidney, and brain) for sustenance—often causing permanent damage to the organs in the process. This is the most serious consequence of anorexia and can possibly lead to cardiac arrest and/or kidney failure, both of which can result in death. "

For those who are anorexic, please take heed. Lanugo may be the least of your worries.

The New England Journal of Medicine


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MrsMenopausal said...

Excellent post and pics. I think that most young women are not aware of what Lanugo looks like. It's certainly not a pretty side effect.

My blog: Weighing The Facts

Mayberryfan said...

Not that this is FUNNY at all because Kimkins and other pro-ana diets do tremendous mental and physical damage to people. But while I was reading this post I thought this phenomenon turns "hirsute" into Here: suit! As in lawsuit. This is just more proof that the people suing Heidi Diaz are absolutely doing the right thing!

Anonymous said...

And yet I find it ironic that there is a t-shirt ad on this site featuring a tiny-waisted big-busted model. Ah, that contradictions of our society..

Anonymous said...

To be fair to Amy Winehouse, mess that she is, I don't think that's lanugo on her face. I'm fairly certain that she just has sideburns and hasn't been to have them waxed. Lord knows my mom had 'em, and she was about as far from anorexic as you can get. Besides, lanugo is is typically fine, downy white hair, and this is black.

Naubiout said...

Like anonymous above, I question whether the last two photos are legitimate cases of lanugo. I came to this site because of curiosity after my sister was diagnosed with an eating disorder. I do not have a problem with eating or a low BMI, but Spanish genes have my neck and upper back looking much like the third girl. Isn't her hair too dark to be lanugo?

Jennywenny said...

In response to anon & naubi;

Not necessarily true. It is true some ethnicities have larger body hair spread than others, but it is *not* true that a person must be clinically underweight to develop lanugo or that lanugo is always white.

I'm "blessed" with maternal French ancestry dominating my appearance--I've got hair so thick that even at my thinnest, when hair would be sliding out en masse in the shower/on the brush, it was reduced only to what most experience as normal thickness. Unfortunately, my legs, arms, (ahem) other places, and eyebrows are so hairy I need a reflective vest in the woods to make sure I'm not mistaken for a bear. I could rock some sideburns like a Beatle. or Rosie O' Donnell.

You get the point.
Though I'm already, naturally, a furry's wet dream, it can get worse. When I was in the thick of it, even though I wasn't medically underweight nor experiencing constant chills, my hairlines seemed to spread everywhere. *Dark* hair encroached on my cheeks, most of the nape of my neck, further down my sides from the armpits, further down my thighs and up above the panty line from my lady forest (almost like a man's "happy trail"). Honey, I had to shave my ass-crack. Why in the hell my body decided that particular area needed more insulation (even when thinner I could pass for a Kardashian in the caboose) I don't know, but there it was.

I did have the very fair, wispy white hairs of lanugo spreading elsewhere then. It was subtle at first, but when I turned in the light, I saw it. It was over my *face*, even my forehead and nose and apples of my cheeks. It was on my neck, breasts, belly, and I imagine probably my back, too.

All of that is gone now that I'm heavier and quit the drunkorexia cycle (bulimia is my lingering foe now)--including the darker spread. Those hairlines have receded back to the appropriate areas, and I don't have alopecia (though sometimes I wish my arms did, they could double for Chewbacca) and coincided with the elimination of the paler all-over-body hairs, so I'm fairly certain it was lanugo.

Anonymous said...

I also question if some of the photos really are lanugo. i come from an Indian background and I always had the sideburns and hair on my arms and so on... I've always eaten a lot and haven't had anorexia, but the hair is still there. I really think for some of us it is ethnicity and not a condition.

andreea said...

I have struggled with anorexia as a teen. I managed to overcome that bastard, it's been almost 9 years now, but let me tell you the permanent organ damage is real. I get complications for every darn little health problem. Say, for example, in my first year at uni there was a mild respiratory infection that everyone in the school got. Two weeks later, everyone was fine and brushed it off as if it was a common cold, while I developed asthma. It got treated treated eventually, but that was one friggin year of problems compared to my colleagues' two weeks. I'm desperately sensitive to weather and barely functional in extreme heat or cold, complete with passing out in the street and weird heart stuff. I have to have a very precise diet to manage to stand on my own two feet because there's lots of stuff my stomach can't digest anymore and I need to carefully plan how to compensate with other types of food, and the classic three meals a day is just not enough anymore. And the list could go on. If this is my health at age 26, imagine what fun old age is gonna be.
Now, I'm not naive to think a scary story will magically convince anyone to *get over it* or *just eat*. I've been there and I know this is utter BS. But I really, truly wish everyone struggling all the strength and courage in the world to get help. Recovery IS possible and definitely worth it! <3 <3 <3
[I mean yeah, I feel like an old hag at 26, but hey, at least I lived to be 26!]

Anonymous said...

I am freaking out right now. I've been struggling with anorexia nervosa and related body dysmorohia off and on for several years. I was recently critically examining myself in the mirror and I noticed that there was a significant amount of dark hair growing in my asshole region; an area where I had never previously developed hair. Is this normal? I feel disgusting. My anus hole also seems especially prominent from behind since my thigh gap is so huge. I feel grotesque and like my ass got stretched out or something.

Anonymous said...

Must see pic to evaluate