Anagen Effluvium Dallas

Anagen Effluvium Hair Loss

Anagen Effluvium

In review, the anagen phase of the hair cycle describes the growth phase of the hair follicle during which time the keratinocytes in the hair matrix are undergoing very high metabolic activity. Chemotherapy drugs that affect the high cell turnover of cancer cells can have direct toxic effects on the rapidly growing anagen hairs, leading to weakening of the hair shaft with abrupt interruption of growth and consequent abnormal breakage patterns along these weakened shafts. Since 90% of scalp hair is typically in anagen phase, there can be considerable loss to the scalp hair during anagen effluvium. anagen_effluvium Telogen hairs that are mitotically inactive are spared. Eyebrows and eyelashes are less affected since they have a lower percentage of hairs in the anagen phase. Since hair loss is not dependent on the cycling from anagen to telogen, the effects of anagen effluvium are rapid with breakage occurring within days to weeks following ingestion of a toxin. If the toxin is not as severe with only weakening of the hair shaft and not breakage, Pohl Pinkus lines can appear in which the hair is tapered without actual fracture.

Drug-Induced Anagen Effluvium

Asparaginase	Idarubicin
Bleomycin	Ifosfamide
Busulfan	Lomustine
Carboplatin	Mechlorethamine
Carmustine	Medroxyprogesterone
Chlorambucil	Melphalan
Cisplatin	Mercaptopurine
Colchicine	Methotrexate
Cyclophosphamide	Mitomycin
Cytarabine	Mitotane
Dacarbazine	Paclitaxel
Dactinomycin	Pentostatin
Daunorubicin	Procarbazine
Docetaxel	Thiotepa
Doxorubicin	Thioguanine
Etoposide	Topotecan
Fluorouracil	Vasopressin
Gemcitabine	Vinblastine
Hydroxycarbamide	Vincristine
Hydroxyurea	Vinorelbine

Loose Anagen Syndrome

anagen_loose Loose anagen syndrome is an inherited disorder that is characterized by premature anagen release. The structural defect lies in the poor binding of the hair shaft cuticle with the inner root sheath cuticle so that with gentle traction during the hair pull test, the anagen hairs are easily removed. Recall that with the hair pull test, only telogen hairs are able to be removed, as firmly rooted anagen hairs are not displaced unless they are forcibly plucked. Loose anagen syndrome predominantly occurs in childhood (usually normal at birth) and may only be identified with periodic episodes of excessive hair shedding. Spontaneous improvement has been noted in over 90% of affected patients.