Loose anagen syndrome - Hair and Scalp
Loose anagen syndrome primarily affects young children with light-colored hair, especially blond and light brown, although individuals with dark-colored hair can also be affected, albeit much less commonly. There is a strong female preponderance and only whites are affected. Typical onset is during infancy and early childhood with the vast majority of cases developing within the first 3 years of life. Adults are rarely affected – those diagnosed are usually family members of affected children.
Children with loose anagen syndrome are otherwise healthy, and most cases will spontaneously improve by adulthood (and occasionally by adolescence). With advancing age, the hair will become longer, denser, and darker; however, it is important to note that loose anagen hairs will still be present, but to a lesser degree. Although no treatment is required, anecdotal evidence has indicated improvement with topical minoxidil therapy.
L67.8 – Other hair color and hair shaft abnormalities
238735005 – Loose anagen hair syndrome
Differential Diagnosis & Pitfalls
- Alopecia areata – characterized by sudden onset of localized alopecia (sharply demarcated round patches) or diffuse alopecia; presence of "exclamation point hairs;" possible loss of eyebrows, eyelashes, and/or body hair; and possible nail abnormalities (especially pitting).
- Telogen effluvium – rarely occurs in childhood; usually a history of a severe illness in the preceding months. Increased number of hairs in telogen phase on hair pull test.
- Anagen effluvium – characterized by sudden onset of copious hair loss; usually a history of a severe illness in the preceding weeks, and/or history of chemotherapy, radiation therapy, or toxic ingestion.
- Trichotillomania – rarely occurs in early childhood; characterized by localized alopecia with bizarre shapes and hairs of irregular length and spontaneous resolution with behavioral therapy.
- Androgenetic alopecia – rarely occurs in early childhood; characterized by male- or female-pattern alopecia, and gradual worsening with advancing age.
- Uncombable hair syndrome (also known as spun glass hair or pili trianguli et canaliculi) – characterized by hair that is unruly and cannot be combed flat thereby resulting in "spun-glass" appearance, although quantity of hair is normal.
- Diffuse partial woolly hair – rare disorder characterized by short, fine, and kinky hair.