Loose anagen syndrome is a benign and self-limiting condition in which the hair is very easily pulled out of the follicles on the scalp. In this guide, you’ll learn more about the loose anagen syndrome, if or when it can be resolved, and what can be done to treat it.
What Is Loose Anagen Syndrome?
Loose anagen syndrome, as the name implies, refers to the hair being loosely anchored into the hair follicles. As a result, it can easily be pulled out of the scalp. So much so that you won’t even feel pain. It is a congenital condition that usually causes diffuse hair loss.
“Anagen” is a phase of the hair growth cycle in which the hair actively grows. Normally, 85-90% of the hair is in this phase at any given time, and it lasts for 2-8 years. During this, your hair will continue to develop and push out of the skin.
Unfortunately, in loose anagen syndrome, it’s believed that the anagen phase is stopped prematurely. And that’s why those who have this condition aren’t able to grow their hair long.
Quite often, it’s reported to occur in young Caucasian girls between the ages of 2 and 5, having blonde hair. However, it can also affect boys, adults, and people of other ethnicities.
Anouar I, Hjira N, Boui M. Loose Anagen Syndrome: A Little Response to Minoxidil. Int J Trichology. 2019 Mar-Apr;11(2):89-91. doi: 10.4103/ijt.ijt_100_18. PMID: 31007480; PMCID: PMC6463455/CC BY-NC-SA 4.0
Short anagen syndrome vs loose anagen syndrome: what is the difference?
The term short anagen syndrome should not be confused with loose anagen syndrome, which is another type of hair disorder.
In short anagen syndrome, the duration of the growing anagen phase is reduced. Normally, the anagen phase lasts for 4 to 7 years, however, it is cut down to just 1-2 years in short anagen syndrome, according to research. As a result, the hair does not grow long.
On the other hand, in loose anagen syndrome, problems in hair keratinization prematurely halt the anagen phase. Although short hair can also be seen in patients with loose anagen syndrome, as has been noted, it’s the “fast turnover of short hairs” that makes it look like the person has short hair that isn’t growing.
What Are The Symptoms Of Loose Anagen Syndrome?
There’s nothing wrong with the hair when the child is born. However, as they grow older, their hair can become:
- Dry
- Short (many don’t even need haircuts)
- Fine
- Lustreless
- Matted
- Sparse
- Limp
- Having different lengths
Also, some people have “bed hair” because the hair at the back of the head (occipital region) rubs against the sheets while sleeping. It’s considered a reason why this type of hair loss is the worst in that area; the friction further plucks the hair out. The hair can also feel sticky and matted because of this. And because it’s difficult to tame this type of hair with combing, it can look quite messy.
Still, the scalp isn’t the only area that can be affected by loose anagen hair syndrome. It can also affect eyebrow hair and body hair.
Types Of Loose Anagen Syndrome
There are three main types of loose anagen syndrome, which are as follows:
- Type A – Hair is short, sparse (low density) and thin
- Type B – Hair is unruly and curly
- Type C – Hair looks normal but excessive shedding takes place
One case study reports that people who have Type A or B loose anagen syndrome can develop Type C at an older age. Its researchers also noted that this type of hair loss doesn’t always have to be sparse or diffuse. It can also occur in a patch.
Leerunyakul K, Suchonwanit P. A Case of Loose Anagen Hair Syndrome in a Southeast Asian Boy. Case Rep Dermatol. 2019 Jul 3;11(2):204-208. doi: 10.1159/000501443. PMID: 31341463; PMCID: PMC6639585/CC BY-NC 4.0
Another important thing to note here is that loose anagen syndrome doesn’t always occur on its own. It can also be associated with other conditions, such as Noonan syndrome, colobomas, uncombable hair syndrome, eczema, etc.
What Causes Loose Anagen Syndrome?
Loose anagen syndrome is considered an “autosomal-dominant” condition, meaning it has a genetic basis.
Autosomal dominant means that a faulty gene was passed down to the child from one of the parents, and that alone was enough to cause this. But the exact way in which this condition develops is not known.
Some, however, suggest that it happens due to issues in a process called “keratinization”— it’s when in the process of hair growth, cells get pushed farther and farther away from the skin, die and harden to form keratin (the major protein in hair).
According to Medscape, abnormalities in the keratinization of the inner root sheath – which protects the growing hair and plays a role in anchoring it – impairs hair attachment within follicles. That is what makes the hair come out easily.
Does Loose Anagen Syndrome Go Away?
Fortunately, loose anagen syndrome is something that children grow out of on their own. It’s a self-limiting condition, so the hair should eventually start to grow. Since loose anagen syndrome is non-scarring, your hair follicles aren’t destroyed. Therefore, it’s not irreversible.
How Long Does Loose Anagen Syndrome Last?
The American Osteopathic College of Dermatology (AOCD) reports there have been cases of loose anagen syndrome that lasted for 14 years.
However, there are patients who’ve also reported improvement while on certain therapies after a few months and even years.
How To Treat Loose Anagen Syndrome?
While there’s no treatment for loose anagen syndrome, there are case reports of minoxidil helping improve hair growth in these patients.
One case report in Pediatric Dermatology found that minoxidil 5% solution significantly helped a 2-year-old girl with loose anagen syndrome. It was given taperingly for a period of 2 years and 4 months.
But other than waiting for the hair to grow back, it’s important to be gentle with your hair. You should avoid tying it too tightly as it’ll pull at the roots. Similarly, don’t be too rough when you’re combing your hair. Even when you’re washing, be very gentle.
How Is Loose Anagen Syndrome Diagnosed?
Your doctor may do a hair pull test and a microscopic examination (trichogram) of your hair to get a diagnosis of loose anagen syndrome.
A hair pull test involves holding 10 to 20 strands of hair near the scalp and pulling them to try and extract them, according to a recent study. Normally, this makes the scalp “tent,” as the hair doesn’t come out. But when a patient has loose anagen syndrome, the researchers note that hairs come out easily and painlessly.
More than 3 or even 10 hairs can be pulled out if a person has loose anagen syndrome, whereas normally, only 1 to 2 hairs come out, according to another research.
Additionally, closer examination of such hairs can reveal certain peculiarities. For instance, the bulbs of such hair are misshapen. Moreover, the cuticle of the hair looks ruffled.
Dhurat RP, Deshpande DJ. Loose anagen hair syndrome. Int J Trichology. 2010 Jul;2(2):96-100. doi: 10.4103/0974-7753.77513. PMID: 21712911; PMCID: PMC3107966/Creative Commons License
Reach Out To Us
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Frequently Asked Questions
There is no “best shampoo” for loose anagen syndrome because it’s an inherited condition. So, no shampoo can change the underlying genetics of your hair. To not exacerbate your hair loss, however, it might be better to use a mild shampoo.
Loose anagen syndrome is a self-limiting condition that can resolve on its own (so a surgical treatment such as a hair transplant isn’t necessary). However, you must still consult a professional healthcare facilitator.
Loose anagen syndrome is a rare hair disorder, as only about 2 cases are reported per million per year. However, it is something that parents of young children should keep an eye out for. That’s because 10% of alopecia cases in children are of loose anagen syndrome, as reported in Disorder of Hair and Nails.
Dr Cagla
Dr Cagla earned her medical degree at Trakya University’s Faculty of Medicine in Bulgaria and has almost 6 years of hair transplantation experience. She is a specialist in FUE, DHI and Sapphire hair transplants of the scalp, eyebrows and beard and has performed over 6,000 surgeries. Dr Cagla is multilingual, with fluency in English, Bulgarian and Turkish.
