Frontal bossing is an unusually prominent forehead. It is sometimes associated with a heavier than normal brow ridge.
Frontal bossing is seen only in a few rare syndromes, including acromegaly, a long-term (chronic) disorder caused by too much growth hormone, which leads to enlargement of the bones of the face, jaw, hands, feet, and skull.
- Basal cell nevus syndrome
- Congenital syphilis
- Cleidocranial dysostosis
- Crouzon syndrome
- Hurler syndrome
- Pfeiffer syndrome
- Rubinstein-Taybi syndrome
- Russell-Silver syndrome (Russell-Silver dwarf)
- Use of the antiseizure drug trimethadione during pregnancy
There is no home care needed for frontal bossing. Home care for disorders associated with frontal bossing varies with the specific disorder.
When to Contact a Medical Professional
If you notice that your child's forehead looks overly prominent, talk to your health care provider.
What to Expect at Your Office Visit
An infant or child with frontal bossing generally has other symptoms and signs. Taken together, these define a specific syndrome or condition. The diagnosis is based on a family history, medical history, and thorough physical evaluation.
Medical history questions documenting frontal bossing in detail may include:
- When did you first notice the problem?
- What other symptoms are present?
- Have you noticed any other unusual physical characteristics?
- Has a disorder been identified as the cause of the frontal bossing?
- If so, what was the diagnosis?
Lab studies may be ordered to confirm the presence of a suspected disorder.
Herring JA. Skeletal dysplasias. In: Herring JA, ed. Tachdjian's Pediatric Orthopaedics. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 40.
Kinsman SL, Johnston MV. Congenital anomalies of the central nervous system. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 591.
Sankaran S, Kyle P. Abnormalities of the face and neck. In: Coady AM, Bower S, eds. Twining's Textbook of Fetal Abnormalities. 3rd ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2015:chap 13.
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.