Frontal Bossing

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Definition

What is frontal bossing?

Frontal bossing is an unusually prominent forehead. It is sometimes associated with a heavier than normal brow ridge. This symptom is the main marker of many conditions, including issues that affect a person’s hormones, bones, or stature. A doctor typically identifies it in infancy or early childhood.

Treatments can address the condition that’s causing the frontal bossing. However, you can’t correct a protruding forehead because frontal bossing changes the way the bone and tissues of the face and skull form.

Frontal bossing causes your child to have an enlarged or protruding forehead or an enlarged eyebrow ridge. This symptom may be mild in the early months and years of your child’s life. However, it may become more noticeable as they age.

Frontal bossing may be a symptom of a genetic disorder or congenital defect, meaning a problem that’s present at birth. The cause of the bossing may also cause other symptoms, such as physical deformities.

How common is frontal bossing?

Frontal bossing is not common. Please discuss with your doctor for further information.

Which signs and symptoms can frontal bossing usually be associated with?

Related signs and symptoms include:

  • Large head size
  • Cleft palate
  • Eyes that are spaced far apart
  • A protruding jaw
  • Spinal problems
  • Irritability
  • Bone pain
  • Joint swelling
  • Distinctive facial feature
  • Intellectual disability

Causes

What causes frontal bossing?

Frontal bossing is usually due to conditions that affect your child’s growth hormones.

The most common underlying cause is acromegaly. This is a chronic disorder that leads to an overproduction of growth hormone. People with acromegaly have larger-than-normal:

  • Hands
  • Feet
  • Jaws
  • Skull bones

Other potential causes of frontal bossing include:

  • Use of the antiseizure drug trimethadione during pregnancy,
  • Basal cell nevus syndrome. Basal cell nevus syndrome refers to a group of defects caused by a rare genetic condition. It affects the skin, endocrine system, nervous system, eyes, and bones. The most common symptom of basal cell nevus syndrome is the development of basal cell carcinoma in adolescence or young adulthood. Basal cell nevus syndrome is also responsible for the development of other cancers early in a person’s life.
  • Congenital syphilis. Congenital syphilis is a severe, disabling, and often life-threatening infection seen in infants. A pregnant mother who has syphilis can spread the disease through the placenta to the unborn infant. Congenital syphilis is caused by the bacteria Treponema pallidum, which is passed from mother to child during fetal development or at birth. Nearly one half of all children infected with syphilis while they are in the womb die shortly before or after birth.
  • Cleidocranial dysostosis. Cleidocranial dysostosis is a disorder involving the abnormal development of bones in the skull and collar (clavicle) area. The condition is passed down through families (inherited). Cleidocranial dysostosis is caused by an abnormal gene. It is passed down through families as an autosomal dominant trait. That means you only need to get the abnormal gene from one parent in order for you to inherit the disease.
  • Russell-Silver syndrome. Russell-Silver syndrome is a growth disorder characterized by slow growth before and after birth. Babies with this condition have a low birth weight and often fail to grow and gain weight at the expected rate (failure to thrive).
  • Rubinstein-Taybi syndrome. Rubinstein-Taybi syndrome is a condition characterized by short stature, moderate to severe intellectual disability, distinctive facial features, and broad thumbs and first toes.
  • Pfeiffer syndrome. Pfeiffer syndrome is a genetic disorder characterized by the premature fusion of certain skull bones (craniosynostosis). This early fusion prevents the skull from growing normally and affects the shape of the head and face. Pfeiffer syndrome also affects bones in the hands and feet.
  • Hurler syndrome. Hurler syndrome is a type of storage disease in the body caused by the lack of one enzyme. The condition varies in severity but is a progressive condition involving many bodily systems.
  • Crouzon syndrome. Crouzon syndrome is a genetic disorder characterized by the premature fusion of certain skull bones (craniosynostosis). This early fusion prevents the skull from growing normally and affects the shape of the head and face.
  • Rickets. Rickets is a skeletal disorder that’s caused by a lack of vitamin D, calcium, or phosphate. These nutrients are important for the development of strong, healthy bones. People with rickets may have weak and soft bones, stunted growth, and, in severe cases, skeletal deformities.
  • Abnormal growths in the forehead or skull.

Abnormalities in an infant’s PEX1, PEX13, and PEX26 genes can also cause frontal bossing.

The conditions mentioned above are some common causes of frontal bossing. Consult with your doctor for an accurate diagnosis.

Risk factors

What increases my risk for frontal bossing?

Please consult with your doctor for further information.

When to see your doctor

When should I see my doctor?

On noticing one of these symptoms or having any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor to get the best solutions for your situation.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage frontal bossing?

There are no known ways to prevent your child from developing frontal bossing. However, genetic counseling may help you determine if your child is likely to be born with one of the rare conditions that cause this symptom.

Genetic counseling may include blood and urine tests for both parents. If you’re a known carrier of a genetic disease, your doctor may recommend certain fertility medications or treatments. Your doctor will discuss which treatment option is right for you.

Always avoid the antiseizure medication trimethadione during pregnancy to reduce the risk of your child being born with frontal bossing.

If you have any questions, please consult with your doctor for the best solutions.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: February 25, 2019 | Last Modified: February 25, 2019

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