By Gary M. White, MD

Diffuse graying of the hair (also called canities) usually occurs as a natural process of aging. Premature graying of hair can occur and is positively correlated with family history (OR 12.8), obesity (2.6), and smoking (1.6) [JAAD 2015;72;321].

Rapid whitening of the hair (e.g., overnight) is probably due to selective loss of only the pigmented hair in alopecia areata. Gradual premature graying may occur in progeria, Werner syndrome, dystrophia myotonica, Book syndrome (palmoplantar hyperhidrosis, premolar hypodontia), after beginning chloroquine, and cri-du-chat syndrome.

Graying of hair may occur in unusual distributions, e.g., unilaterally. [Int J Trichol 2015;7:85-6]

Reports of hair repigmentation are rare, but there are a limited number of cases associated with drugs such as thalidomide, lenalidomide, etretinate, erlotinib, and adalimumab and brentuximab [JAAD Case Reports 2017;3/563]. The latency period between drug initiation and hair repigmentation ranges from 3 months to 3 years. The drug pazopanib turned one man's black hair nearly completely white over 5 months. [Ann Dermatol. 2015 Dec; 27(6): 791–792]


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