frontal bossing

What Is Frontal Bossing?


The most common cause of frontal bossing is acromegaly, a hormonal disorder that causes the pituitary gland to secrete too much growth hormone. This growth hormone causes the bones of the face, skull, jaw, hands and feet to be enlarged. Conditions leading to frontal bossing are rare. Some of them are hormonal disorders, others are genetic (inherited syndromes) and some can be both.

What Causes Frontal Bossing?

The causes for frontal bossing include:


  • Acromegaly*
  • Basal Cell Nevus Syndrome
  • Congenital Syphilis*
  • Cleidocranial Dysplasia (CCD)*
  • Crouzon Syndrome
  • Gorlin Syndrome*
  • Hurler Syndrome*
  • Pfeiffer Syndrome
  • Rubinstein-Taybi Syndrome
  • Russell-Silver Syndrome (Russell-Silver dwarf)*
  • The use of the anti-seizure drug Trimethadione during pregnancy

Acromegaly: Frontal bossing is most prominent on the forehead. It is also associated with heavier than normal eyebrow ridge. Frontal bossing can also be observed in some rare syndromes such as Acromegaly, a long-term chronic disorder caused by too much growth hormone and causing enlargement of the bones of the face, jaw, hands, feet and skull.

Hurler Syndrome: Hurler syndrome can lead to skeletal abnormalities, heart disease, respiratory problems and more. This condition is caused by premature fusion of the cranial bones.

Gorlin Syndrome: Gorlin Syndrome is a disease characterized by skeletal abnormalities, cysts in the jaw and carcinomas (a type of cancer).

Cleidocranial Dysplasia (CCD): Cleidocranial Dysplasia is a disease that affects the teeth, collarbone, spine, skull and legs. It causes the bones to be brittle, and in some cases the bones in the collarbone are completely missing.

Congenital Syphilis: Another possible cause of frontal bossing is congenital syphilis. In this disease, the skull bones fuse, resulting in large severed thumbs and large toes.

Russell Silver Dwarf Syndrome: is a condition that leads to restricted growth in babies at birth. Babies with the condition have a large head, protruding forehead and a triangular face. A condition that can cause growth delays, big thumbs and big toes, mental disability and nutritional problems.

Image of Frontal Bossing

Frontal Bossing In Babies

If you are pregnant with Syphilis, you can pass it on to your baby, which can lead to multiple health problems. Another condition that can lead to frontal bossing after birth is Rickets. Rickets can occur in infants and young children and are caused by a lack of vitamin D. Rickets can also lead to slow development of soft skull bones. Taking Trimethadione, an anti-seizure medication, while you are still pregnant, can also lead to this condition. If you see that your baby’s forehead is larger than usual, you might want to make an appointment with your doctor to check if there are any related problems.

Frontal Bossing Diagnosis

A diagnosis of frontal bossing is made on the basis of a physical examination and the examination of your partner or family history. Your doctor may also ask if you have noticed that the forehead has an abnormal appearance or if there are other symptoms. To confirm the diagnosis of a particular disease, your doctor may order laboratory tests. Blood tests can be used to check genetic conditions and hormone levels. X-rays and magnetic resonance imaging (MRI) can be performed to detect abnormalities or growths in the skull.

frontal bossing surgery
Image of frontal bossing corrective surgery

Does Frontal Bossing Go Away?

Frontal bossing develops with age, in most cases.

There are no known methods to prevent your child from developing frontal bossing. However, plastic surgery can be helpful in treating many facial deformities. There is the possibility of cosmetic surgery to improve the appearance of frontal bossing.

Your doctor will discuss which treatment options are available to you and what is best. Genetic counselling can help you determine whether your child is likely to be born with one of the rare diseases that cause these symptoms. This may include a blood or urine test for both parents. If you are known to be a carrier of a genetic disease, your doctor may recommend certain fertility drugs or treatments.

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