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Living with Pili torti

A rare hair condition with fragile, flattened and twisted hair, which can occur alone or with other conditions.

Understanding Pili torti

Pili torti is a rare hair condition in which hair is fragile and has a flattened shaft with narrow twists.

The twists occur in clusters at irregular spots along the hair. Some cases are inherited, while others are acquired later in life. In the inherited form, signs tend to show up in early childhood. It can occur alone or with other conditions, such as ectodermal dysplasias, Menkes disease, Bjornstad syndrome or Bazex syndrome.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Brittle, flattened and twisted hair
  • Hair loss (alopecia)
  • Changes in hair texture
  • Changes in the eyebrows
  • Nail changes
  • Tooth and tooth enamel changes

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include genetic specialists and skin, hair, and nail specialists.

  3. Ask which tests can help

    Your care team will decide which exams and tests can confirm the diagnosis.

Care & treatment

Care team
Genetic specialists (geneticists); Skin, hair, and nail specialists (dermatologists)
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with Children's Skin Disease Foundation
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Is my pili torti alone, or part of another condition?
Should I be checked for hearing, nerve, nail, sweat gland or tooth problems?
What hair care can help with breakage?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Recessive

GARD says some cases are inherited in an autosomal dominant or autosomal recessive pattern, and others are acquired. It doesn't name a gene.

GeneticSkin

Also known as: flattened and twisted hair; pili torti (disease); pili torti, early-onset; pili torti, ronchese type; twisted hair

Patient organizations

Broader rare-disease groups

Source: NIH GARD · Pili tortiGARD ID 4361 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Pili torti.

Explore the Pili torti blog

Explore research for Pili torti

Explore actively recruiting Pili torti studies with HealthSpark.

HealthSpark

Find actively recruiting studies for Pili torti with HealthSpark. Share your city to explore research near you.

  • Recruiting studies from ClinicalTrials.gov
  • Share your city to look for research near you
  • Eligibility is confirmed by the study team

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Powered by HealthSpark, our AI chat helper · Study information from ClinicalTrials.gov · Eligibility is confirmed by the study team.

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