Skip to main content

Anagen Effluvium

What is it anagen effluvium?

Anagen effluvium refers to hair detachment that arises during the anagen or growth stage of the hair cycle.

This is in contrast to telogen effluvium or shedding of hair that arises during the telogen or resting stage of the hair cycle.

Anagen effluvium is due to a acute hair injury follicles By a endogenous or exogenous cause, resulting in sudden diffuse detachment of structurally damaged hairs. Diffuse alopecia (hair loss) can occur over a period of days. Alopecia leaves no scars.

Who gets Anagen effluvium?

Anagen effluvium is most common in patients of any age, sex or the race that receives chemotherapy.

Individuals with autoimmune Conditions such as alopecia areata and pemphigus vulgaris may be affected.

What causes anagen effluvium?

Any insult that hurts mitosis of hair follicle keratinocytes can cause anagen effluvium. Disruption of cell division in the hair matrix makes the hair narrow at its base and susceptible to breakage just above the hairline area. keratinization. the necrotic matrix shape plugs consisting of melanin, curb and inner root sheath that is extruded through the follicular opening. This process is known as trichomalacia.

The main causes of anagen effluvium are a infectionA drug toxin, radiation, or an autoimmune disease.

An infection can interrupt hair growth in a located area resulting in a unique bald spot patch or various bald patches. Loose hairs can be easily removed from the infected area, which may be swollen, swampy and crusted. Examples include:

  • Boils and abscesses.

  • Fungal hair infection: tinea capitis or kerion.
Anagen effluvium: fungal infection (kerion)

anagen-effluvium-14__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-4008624-4945607

Anagen effluvium: fungal infection (kerion)

anagen-effluvium-15__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-6472742-1633213

Anagen effluvium: fungal infection (kerion)

anagen-effluvium-16__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildbd-6625924-3686812

Anagen effluvium: fungal infection (kerion)

Toxins Which can interrupt hair growth include:

  • Chemotherapy agents, usually prescribed to treat CancerEspecially when using multiple medications or in high doses. Severe hair loss from doxorubicin, nitrosoureas, and cyclophosphamide is reported. Other causes are bleomycin, dactinomycin, daunorubicin, systemic fluorouracil and high doses of methotrexate.

  • Other medications such as colchicine and cyclosporine (cyclosporine most often causes increased hair growth)
  • Poisons such as thallium, arsenic, gold, and bismuth.

Alopecia develops within 2 to 4 weeks of chemotherapy. It affects most parts of the scalp, but other sites may be affected, such as the eyebrows, armpits, and genital area.

Anagen effluvium: loss of eyebrows and eyelashes

anagen-effluvium-04__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-3660319-8738580

Anagen effluvium: loss of eyebrows due to chemotherapy

anagen-effluvium-20__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-6939829-1661487

Anagen effluvium: loss of eyebrows in alopecia areata

anagen-effluvium-19__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-4833506-4033348

Anagen effluvium: loss of eyelashes in alopecia areata

Radiation to the scalp can cause anagen effluvium. Hair regrowth may or may not be incomplete.

Anagen effluvium due to cranial irradiation for melanoma

anagen-effluvium-13__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-9976243-7368628

Anagen effluvium due to cranial irradiation

anagen-effluvium-17__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-3979452-5288362

Anagen effluvium due to cranial irradiation

anagen-effluvium-18__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildg1xq-5683762-2499672

Anagen effluvium due to cranial irradiation

Autoimmune hair loss includes alopecia areata and its variants, total alopecia and universal alopecia. Anagen effluvium can also occur in the rare immunobullous disease, pemphigus vulgaris.

Anagen effluvium: autoimmune disease

anagen-effluvium-07__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-1465562-6601430

Anagen effluvium: lupus erythematosus

anagen-effluvium-08__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-8529522-7912747

Anagen effluvium: alopecia areata

anagen-effluvium-09__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-9364423-6534240

Anagen effluvium: alopecia areata

What are the clinical characteristics of anagen effluvium?

Anagen effluvium occurs with abrupt shedding of most or all of the hair on the scalp and often the entire body, including the eyebrows, eyelashes, and body hair. You can leave your scalp partially or completely bald shortly after traumatic event with up to 90% of hair loss over a period of weeks.

Other characteristics depend on the cause of hair loss.

Anagen effluvium due to chemotherapy

anagen-effluvium-01__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-8605814-2131527

Anagen Effluvium

anagen-effluvium-03__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildg1xq-6384500-7808988

Anagen Effluvium

anagen-effluvium-02__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildg1xq-2958667-5824480

Anagen Effluvium

How is anagen effluvium diagnosed?

Diagnosis of anagen effluvium is usually made by taking a careful history, particularly of recent medications, and examining the scalp and hair clinically and by dermoscopy / trichoscopy.

In anagen effluvium, the end of the hair that comes out of the scalp is tapered, narrow, irregular, or broken. Anagen hairs have long roots covered with inner and outer root sheaths and are pigmented. In contrast, telogen hair is a round bulb or club. Follicular openings remain in both conditions.

Anagen effluvium: hair pull

anagen-effluvium-10__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-1698923-6449286

Anagen effluvium: hair pull

anagen-effluvium-11__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-6832601-1316153

Anagen effluvium: hair pull

A trichogram (forced hair removal within a unit area to determine the ratio of anagen to telogen hair) will show a large proportion of dystrophic anagen hairs.

Scalp biopsy It should reveal a normal anagen to telogen ratio of any persistent hairs in the anagen effluvium due to chemotherapy.

Other tests may be organized to rule out other causes of hair loss, such as iron deficiency, thyroid disease, systemic lupus, and infections (eg, Syphilis).

What is the treatment for anagen effluvium?

Anagen effluvium due to chemotherapy is expected to fully recover within 3 to 6 months after discontinuation. Hair almost always grows back normally, but sometimes straight hair patients develop curly hair when it grows back. Hair color can also change.

Suggested treatments for anagen effluvium include:

  • Current minoxidil solution
  • Cooling of the scalp during chemotherapy
  • Cosmetic camo for eyebrows.

Anagen effluvium: regrowth

anagen-effluvium-05__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildbd-9724955-5142415

Anagen effluvium: new growth after chemotherapy

anagen-effluvium-06__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisinkildg1xq-8065874-9116724

Anagen effluvium: new growth after chemotherapy

anagen-effluvium-12__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-4608104-6750681

Anagen effluvium: regeneration after chemotherapy with curly hair

What is the result for anagen effluvium?

Anagen effluvium is reversible. The hair follicle resumes normal activity after any toxic The agent leaves. Complete regeneration occurs after 3 to 6 months after chemotherapy in most cases. Sometimes hair grows back despite continued chemotherapy.

Anagen effluvium due to alopecia areata may persist; Recovery is unpredictable.