Image credit: Flickr
Image credit: Flickr

Anagen effluvium is a condition wherein an individual experiences hair loss during the hair cycle’s growth or anagen stage. The shedding hair have feathered or tapered root ends, unlike the keratin bulb roots typical of telogen effluvium. Though the scalp is generally the victim, facial hair (eyebrows, eyelashes) and body hair could be affected too.

Unlike telogen effluvium, anagen effluvium’s onset is fairly rapid. This is because 80-90 percent of scalp hair are in the anagen stage at any given time. So when these hairs fall out, the hair loss is far more obvious.

Causes

  • Radiation or chemotherapy could lead to anagen effluvium, and hair regrowth post treatment would be complete within three to six months. In some rare cases, regrowth may not occur or be incomplete.
  • A variety of drugs or medications could cause hair loss, due to the drug’s possible toxic effect on the hair matrix. However, the actual relationship between specific drugs and hair loss is yet not clear.
  • Exposure to chemicals – including boron, thallium, arsenic – could induce anagen effluvium.
  • Other causes may include boils and abscess, kerion or tinea capitis, alopecia areata, endocrine diseases, pressure or trauma, and cicatrizing disease.

Individuals taking anti-cancer medicines could literally pull out their hair in bunches within the initial two weeks of treatment. Drugs don’t provide hair follicles sufficient time to enter their resting state. Instead, the follicles enter a frozen state. The actual level of hair loss may vary with individuals and the anti-cancer medication could result in a blend of telogen effluvium and anagen effluvium.

Diagnosis

The diagnosis entails examination of shed hair and scalp. Complete medical, systemic and dermatologic history is obtained too. Multiple tests could be carried out to eliminate other possible hair loss causes, including malnutrition, thyroid disease, iron deficiency, metabolic and endocrine disorders, infections, collagen disease and systemic lupus.

The tests include thyroid function tests, venereal disease research laboratory test, rapid plasma reagin test, and antinuclear antibody test. If tinea capitis is an issue, microscopic tests for fungal elements could be performed. Some other tests include trichoscanning, phototrichogram, reflectance confocal microscopy and trichoscopy.

Treatment

Topical minoxidil solution is a treatment regularly suggested for anagen effluvium. As anti-cancer drugs are likely to cause anagen effluvium, some treatment centers may resort to cold therapy – a procedure wherein an ice pack or a special cold water-filled hood is used to cover the scalp while anti-cancer medicines are administered. The chillness prevents the follicles from taking the drug up and getting damaged in the process. However, the therapy may prevent the anti-cancer drugs from treating the cancerous scalp cells.