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 are hormonal disorders, others are genetic (inherited syndromes), and some can be both.
What Causes Frontal Bossing?
The causes for frontal bossing include:
- 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-average eyebrow ridges. 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; in some cases, the bones in the collarbone are missing.
Congenital Syphilis: Another possible cause of frontal bossing is congenital syphilis. The skull bones fuse in this disease, resulting in enormous severed thumbs and large toes.
Russell Silver Dwarf Syndrome: This condition restricts babies’ growth 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 toes, mental disability, and nutritional problems.
Frontal Bossing In Babies
If you are pregnant with Syphilis, you can pass it on to your baby, leading 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 the slow development of soft skull bones. While still pregnant, taking Trimethadione, an anti-seizure medication, can also lead to this condition. If your baby’s forehead is more prominent than usual, you might want to make an appointment with your doctor to check for any related problems.
Frontal Bossing Diagnosis
A diagnosis of frontal bossing is made based on 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.
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 help treat many facial deformities. Cosmetic surgery is possible to improve the appearance of frontal bossing.
Your doctor will discuss which treatment options are available to you and what is best. Genetic counseling can help you determine whether your child will likely 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 genetic disease carrier, your doctor may recommend certain fertility drugs or treatments.