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Anagen Effluvium

Do you wake up in the morning with clumps of hair on your pillow and patches missing from your scalp? You might be experiencing anagen effluvium, which is a rapid loss of scalp hair during the anagen phase of the hair cycle, resulting in partial or total baldness (alopecia). Much of society’s standards of youth and beauty are shaped by the health and abundance of our hair, so it is understandable to feel disheartened and embarrassed about losing it abruptly.

Commonly associated with chemotherapy treatment, anagen effluvium is characterized by a disruption in hair growth due to blunt trauma to the hair shaft after exposure to radiation or cancer-fighting chemotherapy drugs. Hair loss usually occurs within two weeks after drug treatment(1) and starts to grow back within several weeks after the treatment ends(2). Oftentimes the new hair growth can temporarily differ in color and texture and in rare cases (3), hair loss can be permanent.

 

The hair growth cycle consists of three phases: anagen (growth), catagen (resting), and telogen (regression). Each strand of hair on your head is constantly cycling through these phases at different times. This explains why it is perfectly normal to lose 80-100 strands a day(4) from a healthy head of hair. Abrupt hair loss from the scalp is called anagen effluvium(5). Excessive shedding beyond the norm is called telogen effluvium(6). The catagen phase is a fairly short transition phase of rest between the two.

The anagen phase of hair growth is a time of continual growth that can last between two to six years with an average of three years(7). Remember mitosis from high school biology class? Hair is constantly undergoing mitosis—dividing and growing—in this phase. When you see a person with lush and shiny hair that cascades effortlessly down their back almost to their behind, you’ll know that their hair is in anagen phase. Abrupt trauma to the hair shaft in this prolific growth phase will result in breakage or complete hair loss, hence why cancer patients often lose most, if not all, of their hair.

In addition to chemotherapy and radiation, there is also a link between anagen effluvium and exposure to infections, poisonous substances, and toxic heavy metals such as thallium, mercury, bismuth, and copper(8). Autoimmune diseases may also be to blame.

 

Anagen effluvium can affect both men and women but can be especially distressing for men without the quick remedy of a wig or headscarf to boost self-confidence. If you are experiencing or expect to experience hair loss due to chemo or radiation treatment, there are a few things you can do to minimize the physical and emotional shock. A tip to minimize the effects of hair loss is to keep your hair cut short to give the appearance of fullness. You should avoid chemical bleaching or heat treatments and limit mechanical damage from excessive brushing. Working with a dermatologist or naturopathic doctor to promote hair growth after treatment is also something you could try. The sooner treatment starts, the better the prognosis.

Small success has been found by inducing “scalp hypothermia” during cancer treatment and by applying topical minoxidil to the scalp area(9), so be sure to ask your doctor about these methods. Some men choose to shave their heads in one fell swoop before the shedding can commence.

 

If you’re not ready to embrace a full shave of your scalp hair just yet, remain optimistic that hair growth should return to its natural cycle once treatment ends.

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Sources:
  1. https://www.ncbi.nlm.nih.gov/books/NBK482293/
  2. https://www.mayoclinic.org/tests-procedures/chemotherapy/in-depth/hair-loss/art-20046920
  3. https://www.ncbi.nlm.nih.gov/pubmed/21430504
  4. https://www.aad.org/hair-shedding
  5. https://www.alopecia.org.uk/faqs/telogen-anagen-effluvium
  6. https://www.health.harvard.edu/a_to_z/telogen-effluvium-a-to-z
  7. https://www.ncbi.nlm.nih.gov/books/NBK482293/
  8. https://www.ncbi.nlm.nih.gov/books/NBK482293/
  9. https://www.ncbi.nlm.nih.gov/books/NBK482293/

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