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Loose
anagen hair syndrome
Loose hair syndrome (loose anagen syndrome, loose anagen hair)
is a non-inflammatory, non-scarring form of hair loss. It is a condition
that has only been defined very recently and which seems to most
likely affect children. So far we know very little about it or how
frequent it is in the general population. Loose anagen syndrome
is a form of hair loss that is often patchy in appearance but can
sometimes have a diffuse presentation. When the hair loss becomes
extensive it most often affects the back of the scalp leaving the
front portion much less affected. As the name suggests, the hair
is loose and is easily pulled out of the hair follicle. This helps
explain why the back of the head is most affected. The repeated
rubbing of the back of a persons head on a pillow at night pulls
out more of the hair, whereas the front of the scalp has less contact
with the pillow and so the hair is more likely to remain in place.
The remaining hair does not grow very long and it can be unruly
and difficult to comb and style.
Hair fibers under a microscope are often irregularly shaped with
longitudinal grooves and ruffling of the cuticle near the base of
the hair shaft. The ruffled cuticle is due to the extraction process
as the hair fiber is removed from the hair follicle. The hair fiber
structure itself is strong. Sometimes the fibers have a spangled
look to them under bright light and very occasionally the fiber
has a tacky feel to it when touched.
The hair follicles affected by loose anagen syndrome are still
in the active growth phase, but the root sheaths that normally surround
and protect the hair shaft are not produced properly. In loose anagen
syndrome the hair fiber is poorly anchored in the hair follicle.
This is due to a lack of adhesion between the hair shaft and the
inner root sheath. It seems that there is premature keratinization
of the inner root sheath and this reduces the adhesion with the
hair shaft. Several research reports that have been published since
its first identification in 1984, involve cases where more than
one genetically related person developed the hair loss. It seems
to have a genetic component that is autosomal dominant, but with
incomplete and variable expression.
Blond haired children age 2 to 5 years are most likely to be affected
but loose anagen syndrome can appear later in life as well. The
syndrome improves with age of its own accord in children but development
in older individuals indicates the hair loss will be more persistent.
There are no known effective treatments.
Loose
anagen hair syndrome references
- Olsen EA,
Bettencourt MS, Cote NL. The presence of loose anagen hairs obtained
by hair pull in the normal population. J Investig Dermatol Symp
Proc. 1999 Dec;4(3):258-60.
- Tosti A,
Peluso AM, Misciali C, Venturo N, Patrizi A, Fanti PA. Loose anagen
hair. Arch Dermatol. 1997 Sep;133(9):1089-93.
- Li VW,
Baden HP, Kvedar JC. Loose anagen syndrome and loose anagen hair.
Dermatol Clin. 1996 Oct;14(4):745-51.
- Chapman
DM, Miller RA. An objective measurement of the anchoring strength
of anagen hair in an adult with the loose anagen hair syndrome.
J Cutan Pathol. 1996 Jun;23(3):288-92.
- Baden HP,
Kvedar JC, Magro CM. Loose anagen hair as a cause of hereditary
hair loss in children. Arch Dermatol. 1992 Oct;128(10):1349-53.
- Price VH,
Gummer CL. Loose anagen syndrome. J Am Acad Dermatol. 1989 Feb;20(2
Pt 1):249-56.
- Sinclair R, Cargnello J, Chow CW. Loose
anagen syndrome. Exp Dermatol. 1999 Aug;8(4):297-8.
- Nunez J, Grande K, Hsu S. Alopecia areata
with features of loose anagen hair. Pediatr Dermatol. 1999 Nov-Dec;16(6):460-2.
- Boyer JD, Cobb MW, Sperling LC, Rushin
JM. Loose anagen hair syndrome mimicking the uncombable hair syndrome.
Cutis. 1996 Feb;57(2):111-2.
- Azon-Masoliver A, Ferrando J.Loose anagen
hair in hypohidrotic ectodermal dysplasia. Pediatr Dermatol. 1996
Jan-Feb;13(1):29-32.
- Pride HB, Tunnessen WW Jr. Picture of the
month. Loose anagen syndrome. Arch Pediatr Adolesc Med. 1995 Jul;149(7):819-20.
- Murphy MF, McGinnity FG, Allen GE. New
familial association between ocular coloboma and loose anagen
syndrome. Clin Genet. 1995 Apr;47(4):214-6.
- Haskett M. Loose anagen syndrome. Australas
J Dermatol. 1995 Feb;36(1):35-6.
- Martinez JA, Velasco M, Vilata JJ, Quecedo
E, Aliaga A. Loose anagen syndrome: a new case. Acta Derm Venereol.
1994 Nov;74(6):473.
- O'Donnell BP, Sperling LC, James WD. Loose
anagen hair syndrome. Int J Dermatol. 1992 Feb;31(2):107-9.
- Trueb RM, Burg G. [Loose anagen hair].
Hautarzt. 1992 Aug;43(8):505-8.
- Tosti A, Misciali C, Borrello P, Fanti
PA, Bardazzi F, Patrizi A. Loose anagen hair in a child with Noonan's
syndrome. Dermatologica. 1991;182(4):247-9.
- Zaun H. Differential diagnosis of alopecia in
children. In: Happle R, Grosshans E (Eds). Pediatric dermatology.
Springer, Berlin, 1984, ppS157-66.
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