When does anagen effluvium occur ?

 WHAT IS ANAGEN EFFLUVIUM ?

Anagen effluvium refers to hair shedding that arises during the anagen or growth stage of the hair cycle . This is in contrast to telogen effluvium  or hair shedding that arises during the telogen on resting stage of the hair cycle . Anagen effluvium is due to an acute injury to the hair follicles by an endogenous or exogenous cause, resulting in sudden diffuse shedding of structually damaged hairs . Diffuse alopecia may occur over a period of days . 



Anagen effluvium is the pathologic loss of anagen or growth - phase  hairs . Classically , it is caused by radiation therapy to the head and systemic chemotherapy, especially with alkylating agents . Anagen effluvium is due to an acute injury to the hair follicles by an endogenous or exogenous cause, resulting in sudden diffuse sheddingof structurally damaged hairs . 

WHAT CAUSES OF ANAGEN EFFLUVIUM ?

Impairs mitosis of hair follicle keratinocytes can cause anagen  effluvium . Disruption to celkl division in the hair matrix makes the hair  narrowed at its base and susceptible to breakage just above the zone of keratinisation . The necrotic matrix forms plugs consisting of melanin , keratin and inner root sheath which are extruded through the follicular opening . this process is known as trichomalacia . 

The main causes of anagen effluvium are an infection , a drug , atoxin , radiation oran autoimmune disease . 

An infection may interrupted hair growth in a localised area resulting in a single bald patches or several bald patches . loose  hairs can readily be extracted from the infected area , which may be swollen , boggy and crusted . example - 

-boils and abscesses

- fungal hair infection : tinea capitis or kerion.

THE CLINICAL FEATURES OF ANAGEN EFFLUVIUM :



Anagen effluvium presents with abrupts shedding of much of r all of the hair on the scalp , and often from the entire body  including eyebrows , eyelashes and body hair . Leave the scalp partically  or completely bald shortly after the traumatic even with up to 90% hair loss over a period of weeks. Other features depend on the cause of the hair shedding . 


HOW TO TREAT OF ANAGEN AFFLUVIUM ?



Anagen effluvium due to chemotheraphy is expected to recover fully within 3-6 months of stopping it . The hair nearly always grows back normally , but sometimes  patients with straight hair develop curly hair when it regrows . Hair color may also change . 

- topical minoxidil solut

- scalp cooling during chemotherapy 

- cosmetic camouflage to eyebrows 

The management os anagen effluvium should be aimed at limiting the amount of time the patient has alopecia . ALthough the results have not been  impressive in stopping the hair loss . Several studies have described limiting drug delivery to the scalp  by using  a scalp  tourniquet during chemotherapy . Another method that has shown sucesse is inducing scalp hypothemia to a scalp temperature  of fewer than 24Celsius during chemotheraphy  with daunorubicin, vinblastine , mechlorethamin , actinomycin D , and epirubicin. Expectation should be managed so that patients understand the unfortunate of the disorder they should also be assured that most cases of anagen effluvium are reverside and they will grow hair once chemotheraphy is ceased . Patient sshould be instructed to avoid chemical trauma to the hair . Patients should be given resources  to obtain hairpiece  or protective scarves befores hair loss and educated on the benefits such  garments offer including cold protection i addition to the aeesthetic component . 

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