What is Anagen Effluvium Hair Loss and Ways To Treat It

by Dr Jaspreet Sarna September 11, 2021

Anagen effluvium leads to sudden hair loss on the scalp. It often extends to the rest of the body including the eyebrows, eyelashes and body hair. In the anagen phase when the hair is hurt due to any toxic or inflammatory abuse, the hair shaft is fractured. When any particular event has an undesirable effect on the regular metabolic function of the hair follicles, anagen effluvium occurs.

One of the reason for sudden hair fall or sudden hair loss is Anagen Effluvium. Anagen Effluvium can affect any person regardless of age and sex. But it is commonly noticed in patients receiving chemotherapy or people with autoimmune disorders, like alopecia. Anagen Effluvium affects almost 85% of the follicles in the growth phase. A massive quantity of hair is lost very quickly and this is because almost 80% of the hair is in the anagen phase at any point in time.

The individuals who are administered cytostatic drugs for cancer treatment often suffer from this type of hair loss. The drug inhibits rapid cell growth and stops the cancer from spreading, but at the same time also prevents the hair follicles from growing.

Some of the other causes of this type of hair loss include iron deficiency, use of oral contraceptives, certain types of infections and malnutrition. The exposure to toxic levels of lead, boric acid, thallium, arsenic, warfarin and bismuth might also lead to this condition.

The most common symptoms associated with anagen effluvium are hair loss, distress, anxiety, change in hair colour or change in hair texture.

Oral medication, Topical medication and cosmetology are some of the popular ways of treating this condition.

What is Anagen Effluvium?

All hair goes through three phases of the hair growth cycle which are classified as Anagen phase , Catagen phase and Telogen phase. Anagen is the growing phase, in which the matrix cells of the hair follicle undergo vigorous mitotic activity. The sudden cessation of mitotic activity causes the partly keratinised section of the hair shaft to weaken and this results in the contraction and subsequent damage within the hair canal. The Anagen phase is generally variable and unless disrupted by various health problems or pregnancy can produce ceaseless and consistent hair production for ten years and more.

Hair fall that occurs during the anagen stage of the hair cycle is Anagen Effluvium. It is one of the reason for sudden hair fall or sudden hair loss.

Despite being in the growth phase the hair discontinues to grow due to enzymatic dysfunctions and environmental factors. This is different from telogen effluvium or hair fall that happens during the telogen or resting stage of the hair cycle.

Anagen effluvium is caused due to an acute injury to the hair follicles by an internal or external force.

Due to certain factors the hair cells stop dividing. This prevents the enzymes from converting into steroids that assist in the keratinisation process for hair growth, leading to weak hair strands. The hair becomes brittle and breaks off easily. The hair fall is rapid. It usually occurs within a few days to a couple of weeks after the hair is exposed to the cause.

Anagen Effluvium might be similar to Loose Anagen Syndrome (LAS) where the hair can be easily and painlessly pulled from the scalp; but the causes for both are different and the hair structure in both these conditions are necessarily different.

Symptoms of Anagen Effluvium

The common symptom of Anagen Effluvium is hair with irregular shape or growth, known as dystrophic anagen hair, Anagen hair

could have thin proximal ends,
be brittle,
be prone to hair thinning,
lead to sudden or fast loss of hair,
result in rapid shedding of a major part of or all hair from the scalp and entire body,
lead to partial or complete baldness of the scalp.

What Causes Anagen Effluvium

One of the reason for sudden hair fall or sudden hair loss is anagen effluvium. When the mitosis of hair follicle keratinocytes is damaged due to some sort of abuse, it causes anagen effluvium. A visit to your dermatologist will help sort out your problem as they take the details of your medical history and take a report on the extraordinary experiences that you might have had recently. A further possibility is a dermatoscopy which will allow them to take a magnified look of your scalp and hair. More details might be required to eliminate other options like a possible thyroid problem.

Anagen effluvium is commonly seen in patients undergoing chemotherapy regardless of factors like age, sex or race. It is a form of nonscarring alopecia.

Autoimmune conditions such as alopecia areata and pemphigus vulgaris can also cause Anagen Effluvium.

Apart from the most common causes like chemotherapy and radiation there can be other causes too. Lack of protein, a drug or an infection, exposure to toxic agents like mercury, boron, thallium, etc., autoimmune disease like pemphigus vulgaris, alopecia areata and systemic diseases associated with peribulbar inflammation, such as systemic lupus erythematosus, secondary syphilis, and others, can also cause anagen effluvium.

Fungal hair infections like tinea capitis or kerion or boils and abscesses may disturb hair growth in a specific area resulting in a single bald patch or several bald patches. The hair can be easily pulled off with hurting.

Treatment Available for Anagen Effluvium

In most cases if Anagen Effluvium is due to chemotherapy which is the reason for sudden hair fall or sudden hair loss, then the hair grows back usually after 3-6 months post the treatment. In most cases the hair grows back to its original texture with some hair colour changes but on occasions the ones with straight hair tend to develop curly hair when it regrows.

Treatment for anagen effluvium includes:

PRP Treatment

Platelet Rich Plasma treatment has led to positive results for many kinds of sudden hair loss in men and sudden hair loss in women. Here a small quantity of blood is extracted from the patient. The platelets are separated and activated using calcium chloride and injected into the scalp using a fine needle into the areas of balding patches. This helps resume the growth cycle of the anagen hair. The flip side of this treatment is the pain induced due to PRP injection, but this subsides as the treatment ends. PRP is a safe treatment and has limited adverse effects with a low recurrence rate.

Topical Medications

Topical Medications like minoxidil, have given positive results for treating chemotherapy induced anagen effluvium. Cyclosporin A, is used as an alternative topical treatment for anagen effluvium, but there have been no reports yet, suggesting its efficacy. Scalp Tourniquet is a device used during chemotherapy infusion to obstruct the blood flow completely. Though not scientifically proven, this treatment has shown positive results in some cases. Scalp cooling during chemotherapy, cosmetic camouflage to eyebrows are some of the other topical treatment methods. Use of a cooling cap is a recommended remedy but this works only if at least 50% of the hair is retained.

Oral Medications

Oral Medications like calcitriol, calcineurin, calcipotriol, etc. These drugs help lessen the severity. They do not however help in regrowth. Oral contraceptives seem to work well for women suffering from anagen effluvium.

Hair Transplant

If the hair loss results in significant bald patches or partial baldness then hair transplant is an option that you could consider. But the cost for anagen hair transplant is significantly high.

Chemical trauma to the hair should be avoided. This includes hot appliances (e.g., bleaching, colouring, perming, using curling irons, or hot rollers), bleach, or colour treatments before or during chemotherapy.

Use satin pillow-covers, as it does not harm weak hair; use a soft brush, use mild shampoo to wash hair. Cut your hair short as it is less noticeable when it is short.

Use an appropriate head cover as it will protect the scalp from sun and cold temperatures.

Can Diet Help with Anagen Effluvium Hair Regrowth?

One of the causes for Anagen effluvium is severe protein deficiency. So, a healthy diet, rich in proteins will definitely help in anagen effluvium hair regrowth. A protein rich diet includes fish, lean meat, beans, and legumes. Even Vitamin D And Vitamin C supplements help.

Essential amino acids and lipoprotein will help you increase those protein levels completely and help improve the condition of your hair.

Dermatologist View on Anagen Effluvium?

Anagen Effluvium is a reversible condition. The regrowth of hair happens after a period ranging from 1-3 months. This can happen when the scalp is allowed to cool down. It is not easy to prevent chemotherapy induced hair loss and therefore it is recommended that the patients be made aware of the potential possibilities that such treatment offers, as part of a systemic practice. The patients should be made comfortable and aware of the process of treatment and the probable post treatment appearance.

Anagen Effluvium can begin right after chemotherapy begins and complete hair loss will be seen within 2-3 months. The effects however vary for different individuals and depends on the specific medication, the administered dose and period of treatment among other things. At times one could experience a combination of telogen effluvium and anagen effluvium which could lead to complete baldness.

The hair loss resulting from chemotherapy begins from the crown and the sides. This is because of the aggravated friction during sleep and due to certain head gear. The hair loss is inconsistent during the initial period depending on the number of hairs during this phase. Hair growth happens again after 1-3 weeks of stopping chemotherapy. This hair is however of a different texture, colour or waviness.

A thorough physical examination is necessary to establish the trigger of hair fall. It could be a result of a metabolic disorder, certain deficiencies, collagen vascular diseases or skin infections and diseases. In anagen effluvium a tapered fracture of the hair shafts is seen.

Hair pull test and trichogram are the most popular methods of the diagnosis of anagen effluvium and is frequently used to differentiate it from telogen effluvium. At times light microscopy might be used to differentiate between anagen and telogen hairs.

Anagen effluvium is reversible in most cases with a good hair care regime. A temporary use of a wig may help the patient deal with the problem temporarily. Hair loss as a result of chemotherapy could be permanent and the efforts are always designed to prevent the period and extent of loss. The most significant approach to reduce hair loss is by diminishing the quantity of drugs delivered to the follicles with the help of various processes like obstructing the flow of blood with a tourniquet or with the help of induced hypothermia of the scalp.

There is a continuous effort to develop a hair protection remedy that will serve as a localised treatment process for the hair follicle without impacting the chemotherapy. There is a need to customise the treatment process with reference to the patient characteristics with the help of different chemotherapeutics to deal with various patients. Also sustained efforts need to be made to prepare a patient to deal with the definite possibility of hair loss. A number of patients tend to be devastated when confronted with severe hair loss. A positive approach wherein the patient is told about the temporary nature of the loss and the likelihood of very normal hair growth that will occur after the completion of the treatment process will help prepare the patient for the road ahead. This is because on occasions the trauma experienced by the patient is so severe that he/she stops considering treatment options thereby adversely impacting any possibility of regrowth.

Anagen Effluvium or hair shedding that happens during the phase when ideally one should be experiencing rapid hair growth can be quite distressing for the individual. It however pays to have a positive mindset and take the help of professionals to tide over this temporary tressy crisis. The good news is quite a few patients experience regrowth within just a few weeks after treatment is stopped and could even find their hair regrowing during the treatment itself. Do visit us at Traya to find out from our experts on how to tackle this stressful phase of your life and minimise the adverse effects.

FAQs

What is anagen effluvium?

Anagen Effluvium is a condition in which the individual experiences increased hair shedding and thinning of hair on the scalp. However rarely does a person lose all their hair.

What is the cause of anagen effluvium ?

Anagen Effluvium is the result of the impairment of the metabolic activity of the hair follicles. If the individual is exposed to chemotherapeutic agents or radiotherapy this type of hair loss happens. It can be caused by several emotional and physical factors like certain types of medication including chemotherapy, toxins, a poor diet, emotional stress, pregnancy and childbirth and chronic illnesses among other things.