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Anagen Effluvium – What Is Anagen Effluvium?

Anagen effluvium is the pathologic loss of anagen hairs, classically caused by radiation therapy to the head and systemic chemotherapy, especially with alkylating agents.

Normal human hairs can be classified according to the 3 phases of their growth cycle: anagen, catagen, and telogen. Anagen hairs are in a growing phase, during which the matrix cells of the hair follicle undergo vigorous mitotic activity. These hairs have long, indented roots covered with intact inner and outer root sheaths, and they are fully pigmented.

Toward the end of the anagen phase, the amount of pigment decreases at the base of the follicle, which expands to form a keratinized club. Then, the hair enters the catagen phase, a transitional phase in which mitotic activity decreases. The follicle separates from the dermal papilla and the capillary plexus and moves upward within its connective tissue sheath toward the epidermis. The resulting telogen hairs, or club hairs, are in a resting phase. These hairs have short, club-shaped roots that anchor them in the follicle. They lack root sheaths and show depigmentation of the proximal part of the shaft.

The hairs continue in this resting state until the follicle spontaneously reenters the anagen phase. At this point, the club hairs are forced out by growing hairs underneath them, and the cycle begins anew. The cycle is not synchronous throughout the scalp; patches of hair may be synchronized. The length of each phase of the cycle, as well as the length of the entire cycle, varies with the site and the age of the patient. In the scalp, for example, the average length of the anagen phase is 1000 days; that of the catagen phase, only a few days; and that of the telogen phase, 100 days. Of the 100,000 hairs on the average scalp, 10-15% are in the catagen or telogen phase at any time. Most hair follicles are in the anagen stage at any given time.

There are literally hundreds of different diseases commonly associated with hair loss. While most of them fall under the term of alopecia, there are others that are stand alone and can also be far more devastating to say the least. This is certainly the case when it comes to anagen effluvium. While largely a mystery in some cases, this form of hair loss has certain markers that make it unique among the other diseases that are currently known. The first part of this disease refers strictly to the cycle of hair growth that naturally occurs with in the human body. The second part of the name is the way in which the hair that is growing is lost and how fast it progresses through the cycle eventually resulting in large patches of hair loss and thinning hair on the scalp

When anagen effluvium occurs it is the direct result of some traumatic occurrence in the body. The issue revolves around the division of cells as they relate to the growth of hair and the ways in which the hair will grow over time. The most common of these occurrences if the chemical therapy used to treat most cancers. Chemotherapy is actually the act of injecting poison into the body the will attack the cancer cells. The problem is that the poison also attacks other parts of the body, such as the cells that grow hair. When this happens the patient will lose their hair and will not re-grow any until the treatments have ceased. Most often the effects of this kind of therapy are only temporary and the effects will reverse when the treatments are no longer present.