Anagen Effluvium

Anagen effluvium is a type of hair loss characterized by an abrupt interruption of the anagen (growing) phase of the hair follicle, typically caused by chemotherapy agents. The anagen phase is highly metabolic, with rapid keratinocyte proliferation in the hair matrix. Chemotherapy drugs, which target rapidly dividing cancer cells, can also affect anagen hairs, leading to extensive hair loss. Most scalp hair (90%) is in the anagen phase, while telogen hairs, which are not actively dividing, are usually unaffected. Eyebrows, eyelashes, and body hair may be variably affected but are generally less impacted due to fewer anagen hairs.

Hair loss usually begins about two weeks after starting chemotherapy and is generally reversible three to six months after completing treatment. However, some agents may cause prolonged or even permanent hair loss. Cold caps filled with ice or coolant may help reduce or prevent hair loss in some patients undergoing chemotherapy.

Anagen effluvium is commonly caused by alkylating agents, antitumor antibiotics, antimicrotubule agents, and topoisomerase inhibitors, such as:

• Bleomycin
• Carboplatin
• Cisplatin
• Cyclophosphamide (IV)
• Daunorubicin
• Docetaxel
• Doxorubicin
• Epirubicin
• Eribulin
• Etoposide
• Fluorouracil
• Gemcitabine
• Idarubicin
• Ifosfamide
• Irinotecan
• Ixabepilone
• Mechlorethamine
• Methotrexate
• Paclitaxel
• Vincristine