Can you get a flat head as an adult? Understanding causes and options

While most people associate flat head syndrome with infants, the reality is that cranial asymmetries can manifest or become more pronounced later in life. Can you get a flat head as an adult? The short answer is yes, although the mechanisms are different and less common than in infancy due to the fused nature of the adult skull.

Quick Summary

The adult skull is a rigid structure, so positional flattening from sleeping or carriers, as seen in infants, is not possible. However, existing untreated infant flat head syndrome (plagiocephaly) can persist into adulthood, and new or worsening head shape changes can occur in rare cases from severe trauma, certain medical conditions, or underlying developmental issues that were never corrected.

Key Points

• Adult skulls are rigid: Unlike infants, whose skulls are soft and moldable, adults have fused cranial sutures, making simple positional flattening impossible.

• Persistent childhood condition: The most common cause of an adult flat head is a severe case of infant plagiocephaly that was never treated and did not self-correct.

• Rare adult causes: New flat spots in adulthood are rare and result from severe head trauma, untreated craniosynostosis, or other medical conditions, not from sleeping position.

• Surgical correction only: Non-invasive methods like helmets are only effective for infants. Adults seeking physical correction must consider complex surgical procedures, such as skull contouring or implant surgery.

• Focus on cosmetic and psychological aspects: For many, the flat head is a cosmetic concern. Management often involves addressing self-esteem through counseling, exploring different hairstyles, or undergoing surgery.

• Typically not medically dangerous: In most cases, having a flat head as an adult does not pose a medical danger, but severe cases can lead to psychological distress or practical issues with protective headgear.

Can a flat head develop in adulthood?

Unlike an infant's soft, pliable skull, which is vulnerable to external pressure from positioning, an adult's skull is composed of fused bones that are no longer susceptible to simple positional molding. The flat head syndrome (plagiocephaly or brachycephaly) commonly seen in babies is primarily a cosmetic issue and often resolves or improves as the child becomes more mobile and spends less time on their back. However, when infant plagiocephaly is severe and left untreated, the cranial asymmetry can persist throughout life. Furthermore, while rare, new or worsening head shape changes can occur in adulthood due to specific underlying conditions.

Causes of adult flat head or cranial asymmetry

Several factors can lead to a flat head or other cranial irregularities in adulthood, none of which are related to simple positioning.

1. Untreated Infant Plagiocephaly: The most common reason for an adult to have a flat spot is that they were never treated for positional plagiocephaly as an infant. While mild cases often improve with growth, moderate to severe cases can persist indefinitely. As awareness of infant plagiocephaly has increased in recent decades, more adults may be seeking answers for a condition that was not addressed during their childhood.
2. Craniosynostosis: In some rare cases, a condition called craniosynostosis, where one or more of the fibrous sutures in an infant's skull fuse prematurely, may go undiagnosed until later in life. This condition restricts brain growth and can lead to an abnormal head shape. In adults, this might present as an asymmetrical or unusually shaped head that has been present since childhood but was previously attributed to other causes.
3. Traumatic Brain Injury (TBI): Severe head trauma can alter the shape of the skull, though this is related to a fracture and subsequent healing rather than simple flattening. These injuries can lead to skull deformities that may require reconstructive surgery.
4. Underlying Medical Conditions: Certain rare medical conditions that affect bone growth, density, or structure can potentially lead to cranial deformities over time. Conditions impacting cerebral blood flow or bone integrity might influence skull shape.
5. Neurological Issues: Some neurological issues might be associated with an altered head shape, though the causal link is complex and still under investigation. Research has explored links between cranial variations and certain neurological or mental health conditions, though this does not mean the flat head causes the neurological issue.

Adult vs. infant head flattening: A key comparison

Understanding the fundamental differences between infant and adult cranial development is crucial for differentiating the causes and treatment options for a flat head. This table highlights these key distinctions.

Aspect	Infant Plagiocephaly	Adult Cranial Asymmetry
Skull Structure	Soft, flexible, and unfused cranial sutures allow for easy molding.	Fused, rigid cranial sutures prevent simple positional changes.
Primary Cause	External pressure from prolonged positioning on a flat surface.	Untreated infant condition, severe trauma, genetic factors, or other medical issues.
Treatment Options	Repositioning, tummy time, and cranial remodeling helmets are effective.	Limited to surgical procedures like contouring, implants, or more extensive reconstruction.
Self-Correction	Mild cases often self-correct as the baby gains mobility.	No self-correction; the shape is permanent without intervention.
Severity	Ranges from mild to severe, typically cosmetic in nature.	Usually a persistent, untreated childhood condition or caused by specific adult medical issues.

Are there any health risks associated with a flat head in adults?

For most adults with flat head syndrome resulting from untreated infant plagiocephaly, the condition is purely a cosmetic concern with no associated health risks. However, in severe cases, there can be practical and psychological implications.

• Practical Difficulties: A significantly misshapen head can make it difficult to find protective headgear that fits properly, such as helmets for cycling, sports, or work in construction or emergency services.
• Psychological Impact: Adults with an abnormal head shape may experience self-esteem issues, anxiety, or social isolation. This can impact social interactions and quality of life.
• Associated Conditions: In very severe or complex cases, particularly those caused by conditions like craniosynostosis or trauma, there can be additional issues. These can include facial asymmetry, jaw misalignment, or temporomandibular joint (TMJ) problems.

How to address and manage a flat head as an adult

Since the skull bones are fully fused, non-surgical methods like helmets, repositioning, or physical therapy, which are effective for infants, are not viable for adults. The options available to adults are more invasive and are primarily for cosmetic improvement rather than functional correction.

Surgical options

For adults who are significantly concerned about their head shape, surgical intervention is the only way to achieve a physical change. These procedures are typically expensive, carry risks, and are only performed by specialized craniofacial or plastic surgeons.

1. Skull Contouring (Burring): This procedure involves reshaping the skull by filing down bony prominences to create a more rounded appearance. It is best suited for addressing smaller irregularities and is performed under general anesthesia.
2. Implant Surgery (Cranioplasty): For larger or more severe flattening, the surgeon can insert custom-made implants to augment the skull. These can be made from materials like medical-grade silicone or bone cement (MMA), which are molded to fit the specific area. This procedure can provide a more balanced and uniform look. For further reading on surgical options, this article provides more detail on the use of bone cement implants: https://www.lineps.com/occipital-back-skull-reshaping/.
3. Orthodontics and Facial Surgery: In cases where asymmetry affects the jaw or facial features, a combination of orthodontic work and maxillofacial surgery might be required.

Non-surgical management

For many, surgery is not a practical or desirable option due to the costs and risks. Non-surgical management focuses on the psychological and social aspects of living with a head shape abnormality.

1. Therapy and Counseling: Working with a psychologist can help individuals address self-esteem issues and cope with the psychological impact of a perceived abnormal appearance.
2. Hairstyling: Using specific hairstyles can be an effective way to camouflage a flat spot. Longer, thicker hair can conceal the asymmetry more effectively than shorter styles.
3. Mindfulness and Self-Acceptance: For some, learning to accept and embrace their appearance is the best path forward. Focusing on mental and physical health and understanding that the condition is often benign can significantly improve well-being.

Conclusion

While adults cannot develop a flat head from simple positioning like infants, they can have a flat head that persists from untreated infant plagiocephaly or, in rare cases, from trauma, craniosynostosis, or other medical conditions. For adults, the cranial sutures are fused, rendering non-surgical interventions ineffective. The only physical treatments available are invasive surgical procedures, which are costly and carry risks. For many, managing the cosmetic and psychological aspects through counseling or hairstyle adjustments is the most practical solution. The increasing awareness of infant plagiocephaly means that future generations may experience fewer cases of persistent cranial asymmetry, emphasizing the importance of early diagnosis and intervention in infancy.

Frequently Asked Questions

Can sleeping on your back cause a flat head in adults?

No. The adult skull is fully formed and rigid, with fused plates. Unlike a baby’s pliable skull, an adult's cannot be reshaped by sleeping in one position. Any flatness in an adult is either from a condition that was never treated in infancy or, in very rare cases, from trauma or a medical issue.

What is the most common cause of an adult having a flat head?

The most common cause is untreated or severe infant plagiocephaly (flat head syndrome) that did not fully resolve on its own. As an infant, the skull was soft enough to be affected by external pressure, and if the condition was not treated, the asymmetry can persist into adulthood.

Can I use a cranial helmet to fix my flat head as an adult?

No, cranial helmets are not effective for adults. They work by gently guiding a baby’s pliable skull as it grows. The adult skull is already fused and cannot be reshaped by a helmet.

Is having a flat head as an adult dangerous?

For most adults, having a flat head is primarily a cosmetic concern and is not considered medically dangerous. It does not affect brain development. In severe cases, however, there can be psychological impacts or practical issues with wearing protective headgear.

What are the treatment options for an adult flat head?

The only way to physically change the shape of an adult skull is through surgery, such as skull contouring (burring) or custom-made implants. Non-surgical options include counseling to address psychological concerns and using hairstyles to camouflage the asymmetry.

Can a flat head in adults be a sign of a more serious medical condition?

In rare instances, a significantly abnormal head shape could be related to an underlying medical issue, such as craniosynostosis that was missed in infancy, or the result of a severe traumatic injury. However, for most people, a flat head is not a symptom of a new, developing serious condition.

What if I have facial asymmetry along with my flat head?

Facial asymmetry is sometimes associated with more severe cases of infant plagiocephaly. While many adults live with this condition without issue, in some cases, it can lead to functional problems with the jaw or dental alignment. If this is a concern, consult a craniofacial or maxillofacial specialist.