What The Health?! Spanish health authorities issue alert after children develop 'werewolf syndrome'

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Spanish health authorities have issued an alert after more than a dozen children developed a rare condition known as “werewolf syndrome,” which is marked by excessive hair growth.

The kids apparently acquired the disorder—which goes by the medical term hypertrichosis—through tainted medication.

After 13 children presented to doctors with abnormal growth of hair, the Spanish Agency for Medicines and Health Products recalled several multiple batches of omeprazole, a drug that treats stomach problems such as acid reflux and ulcers by decreasing the amount of acid the stomach produces.

Lab tests showed that the omeprazole was contaminated with minoxidil, a medication to treat male-pattern baldness. Some of the pharmaceutical products that the kids ingested were intended for use in animals by veterinarians.

At least three more cases of youth with hypertrichosis were later reported.

The drug’s manufacturer, Málaga-based FarmaQuímica Sur SL—which also makes cosmetics—had its licence to produce pharmaceutical products temporarily suspended.

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The children affected were expected to see a “spontaneous reversal of hypertrichosis” once they stopped taking the contaminated medicine.

Acquired hypertrichosis, as in the case of the kids from Spain, can occur from the use of a medication as an intentional outcome or side effect, says Dr. Monica Li, clinical instructor in the department of dermatology and skin science at the University of British Columbia.

“If hypertrichosis occurs as a result of the use of a medication, stopping the medication is important, after consulting a physician,” Li says. “There are medications that are commercially available to stimulate hair growth, such as on the scalp or eyelashes. If these medications are applied inappropriately, or not as directed by a physician, excess hair growth may occur at unintended body sites.”

Other medications have been known to cause acquired hypertrichosis, including anti-convulsants and corticosteroids, according to a 2015 study out of Italy’s University Hospital “Policlinico-Vittorio Emanuele, published in the Italian Journal of Pediatrics. It can also result from malnutrition, anorexia nervosa, endocrine disorders, infectious diseases, and metabolic diseases, among other conditions.

Sometimes, hypertrichosis at a focal body site may be secondary to trauma, friction, or inflammation of the skin, Li notes. Yet another link seen with hypertrichosis involving large areas of the body is malignancy, although this is infrequent.

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Congenital hypertrichosis (present at birth) is extremely rare, with only about 50 cases ever documented. (In the 19th century, some people with “werewolf syndrome” were exhibited at circuses and fairs.)

Congenital generalized hypertrichosis is characterized by hair growth on the face, trunk and limbs, causing significant emotional distress and embarrassment.

In most of these cases, hypertrichosis is not an isolated symptom but rather is associated with other clinical signs including intellective delay, epilepsy, or complex body malformations.

“Hypertrichosis can be seen in a number of uncommon to rare inherited conditions and syndromes seen at birth,” Li says. “These inherited conditions and syndromes often have involvement of other important organs, such as the brain and eyes.”

There are different approaches to the treatment of excess hair, including cosmetic procedures like bleaching, trimming, shaving, plucking, or waxing. Intense pulsed light-source, electrolysis, and laser treatments can be effective, while topical pharmacological ointments are sometimes used.

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Li says that people should always seek medical advice if they have unusual, excessive hair growth.

“Aside from the often-unwanted appearance of excess hair growth, hypertrichosis can be part of a complex medical matter,” Li says. “It is important to treat the underlying medical context leading to excess hair growth along with the excess hair growth itself.

“If hypertrichosis is part of an inherited condition or syndrome seen at birth, where there may be a negative impact on other organs, physicians from different specialties—for example, neurologists or ophthalmologists—are needed to manage these effects. Prioritize seeking medical attention and physician advice over removal of excess hair growth so that your health needs are cared for adequately and appropriately.”

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