Anagen Effluvium

Aka: Anagen Effluvium, Chemotherapy-Induced Hair Loss, Chemotherapy-Induced Alopecia

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II. Definition

  1. Abnormal, abrupt diffuse Hair Loss during Anagen phase

III. Pathophysiology

  1. Inciting event impairs Hair Follicle mitotic and metabolic activity during Anagen phase (active phase)

IV. Causes

  1. Systemic conditions
    1. Mycosis Fungoides
    2. Pemphigus Vulgaris
  2. Medications
    1. Chemotherapy (affects 65% of patients)
      1. Cyclophosphamide
      2. Nitrosureas
      3. Doxorubicin (Adriamycin)
    2. Endocrine
      1. Tamoxifen
      2. Bromocriptine
    3. Elements
      1. Bismuth
      2. Arsenic
      3. Gold
    4. Miscellaneous
      1. Allopurinol
      2. Levodopa

V. Symptoms

  1. Diffuse hairs loss onset days to weeks (peaks at 1-2 months) after offending agent (often Chemotherapy)

VI. Management

  1. Wig until resolution
  2. Hair cooling has been shown effective in Chemotherapy induced Hair Loss
    1. However cooling is not recommended, as it may reduce medication distribution to the scalp

VII. Course

  1. Typically reversible after cessation of offending agent
  2. Hair regrowth starts 1-3 months after stopping agent

VIII. References

  1. Phillips (2017) Am Fam Physician 96(6): 371-8 [PubMed]

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