Yellow hair following sequential application of bacitracin zinc and selenium sulfide: Report of acquired xanthotrichosis and review of yellow hair discoloration

Abstract

BackgroundAcquired yellow hair (xanthotrichosis) can result from the deposition of pigmented compounds on the hair shaft or from chemical modification of hair pigment and protein molecules. PurposeA white-haired 77-year-old woman who developed xanthotrichosis of her scalp hair following the sequential application of bacitracin zinc ointment and selenium sulfide 2.5% lotion is described and the causes of yellow hair discoloration are reviewed. Materials and methodsThe clinical features of a woman with acquired yellow hair discoloration are presented. Using PubMed and Google Scholar, the following terms were searched and relevant citations were assessed: bacitracin zinc, hair discoloration, selenium sulfide, xanthotrichosis, and yellow hair. ResultsYellow hair was observed on the scalp in areas treated with the following regimen: prior to bedtime, several areas of the scalp were treated with a single application of bacitracin zinc ointment. The next morning, selenium sulfide 2.5% lotion was applied and then rinsed from the scalp during showering. Yellow hair discoloration was apparent in co-treated areas immediately following rinsing; the discoloration gradually faded over 2-5 days with regular shampooing. ConclusionsAcquired yellow hair shaft discoloration has been reported secondary to multiple etiologies, including environmental and occupational exposures, iatrogenic causes (including topical and systemic drugs) and protein-calorie malnutrition. To this list, we add yellow discoloration of white scalp hair due to application of selenium sulfide following topical use of bacitracin zinc in the affected areas as an unexpected adverse effect that may occur in individuals with white hair.

Tomato Plant-Associated Xanthoderma: Case Report and Review of Exogenous Causes of Yellow Skin

“…In addition, yellow discoloration can affect the cutaneous appendages such as the hair and nails. The etiology of these changes can be secondary not only to endogenous causes such as systemic conditions or medications but also to exogenous sources [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. In addition to reviewing the etiology of exogenous xanthoderma, this paper also summarizes the causes of exogenous yellow hair and yellow nails.…”

“…Xanthotrichosis, or yellow hair, can result from yellow bacterial concretions most commonly on the axillary hair shaft and designated as trichobacteriosis, which was previously referred to as trichomycosis; it is caused by Corynebacterium species -such as Corynebacterium tenuis and Corynebacterium flavenscens -which are gram-positive diptheroids that colonize the affected hair [7]. Topical contact with numerous exogenous agents can result in yellow hair (Table 1) [2,3,[8][9][10][11][12][13]. "Smoker's mustache" refers to tobacco-associated yellow discoloration of upper lip hair in men who smoke cigarettes and cigars; it is more readily observed in men with light-colored hair or age-associated white hair [12].…”

“…Anthralin a [8] Curing agent Z b [9,10] Copper [8] Dinobuton c [11] Dihydroxyacetone d [8] Hydrogen peroxide [8] Hypochlorous acid [8] 4,4'-Methylenedianiline (MDA) b [9,10] 4,4'-Metaphenylenediamine (MPD) b [9,10] Minoxidil (1.5%) [8] 1-naphthol derivatives [8] Picric acid [8] Resorcinol [8] Selenium sulfide e [8] Tar shampoo [8] Tobacco [2,3,12] Trinitrotoluene f [11,13]…”