loose anagen hair syndrome

Loose Anagen Hair Syndrome (LAHS) Description

Loose anagen hair syndrome (LAHS), also known as loose anagen syndrome, is a rare benign hair disorder that affects predominantly blond females in childhood and adolescence. The condition is characterized by the presence of hair that can be easily and painlessly pulled out from the scalp.

Key Features:

• Easy hair shedding: Hairs are loosely anchored to the scalp, making them easy to pull out.
• Painless hair extraction: Hair can be extracted without causing any discomfort or pain.
• Anagen phase hairs: Most of the affected hairs are in the anagen phase, which is the growth phase of hair follicles.
• Lack of external epithelial sheath: The affected hairs lack an external epithelial sheath, making them more prone to shedding.

Demographics:

• Predominantly affects blond females: LAHS is most commonly reported in young, fair-haired girls.
• Can be familial or sporadic: The condition can be inherited in an autosomal dominant fashion with incomplete penetrance or occur as sporadic cases.

Other characteristics:

• Non-scarring alopecia: LAHS is a type of non-scarring alopecia, meaning it does not lead to permanent hair loss.
• Increased hair shedding: People with LAHS may experience increased hair shedding due to poorly anchored anagen hairs.

References:

[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14]

Loose anagen hair (LAH) syndrome, also known as loose anagen syndrome (LAS), is a rare benign hair disorder characterized by the easy and painless detachment of anagen staged hairs from the scalp. The primary signs and symptoms of LAH syndrome include:

• Diffuse hair loss: A significant number of hairs are easily pulled out from the scalp, leaving behind a "bed head" appearance [4][9].
• Easy and painless hair detachment: Hairs can be easily and painlessly pulled out from the scalp, without causing any discomfort or pain [2][5][6].
• High percentage of loose anagen hairs: A trichogram (a test that examines a sample of hair) will show at least 70% to 80% loose anagen hairs, with some cases showing up to 100% [3].
• Hair growth rate: Hair grows back quickly, and the condition improves spontaneously with aging [5][9].
• Lack of external epithelial sheath: Most of the hair is in the anagen phase and lacks an external epithelial sheath [5][9].

It's worth noting that loose anagen syndrome primarily affects children, particularly those with fair hair. The condition can be diagnosed clinically using a few tests, including a hair pull test to determine how easily hair is pulled out from the scalp [13].

Loose anagen hair syndrome (LAHS) can be diagnosed through several tests, which are essential in confirming the condition. Here are some diagnostic tests used to diagnose LAHS:

• Hair Pull Test: This is a crucial test for diagnosing LAHS. It involves gently pulling 40-60 hairs from the scalp to assess the number of loose anagen hairs (LAHs). In individuals with LAHS, at least 3-10 LAHs are extracted painlessly [2][4]. A positive hair pull test result is considered a hallmark feature of LAHS.
• Trichogram: This test involves forcibly extracting 50-100 hairs using a rubber-tipped clamp or hemostat. In individuals with LAHS, the trichogram will reveal at least 70-80% loose anagen hairs [13]. A high proportion of anagen hairs (frequently close to 100%) is often observed in LAHS patients.
• Clinical Evaluation: A dermatologist's clinical evaluation plays a significant role in diagnosing LAHS. The condition typically presents in young girls with short, blond hair and diffuse or patchy thinning [3]. The diagnosis is confirmed by the painless extraction of microscopically confirmed anagen hairs through gentle hair pulling.
• Blood Tests: While not directly diagnostic for LAHS, blood tests may be performed to rule out other conditions that could cause similar symptoms. However, these tests are not specific for LAHS and should not be relied upon as a primary diagnostic tool [6].
• Biopsy: In some cases, a biopsy may be performed to confirm the diagnosis of LAHS. However, this is typically not necessary for diagnosing the condition.

It's essential to note that a negative hair pull test does not exclude LAHS, and a trichogram is often used in conjunction with other tests to confirm the diagnosis [11][12].

Loose anagen hair syndrome (LAHS) can be treated with various medications, including:

• Minoxidil: This medication has been shown to be effective in treating LAHS by encouraging hair growth and reducing shedding. Studies have reported good results with topical minoxidil 5% lotion [6][7].
• Biotin supplements: While there is no scientific evidence to support the use of biotin supplements for LAHS, some studies suggest that it may be beneficial in promoting hair growth [3].
• Zinc supplementation: In one study, zinc supplementation was found to slow down hair loss without improving hair growth in patients with LAHS [7].

It's essential to note that these treatments are not universally effective and may require trial and error to find the best approach for individual cases. Additionally, treatment should be tailored to the specific needs of each patient, taking into account factors such as age, severity of symptoms, and overall health.

References:

[3] - Context result 3 [6] - Context result 6 [7] - Context results 7

Loose anagen hair syndrome (LAHS) can be challenging to diagnose, and it often requires a differential diagnosis to rule out other conditions that may cause similar symptoms. Based on the search results, here are some conditions that should be considered in the differential diagnosis of LAHS:

• Alopecia areata: This is a common condition characterized by patchy hair loss, but it can also present with diffuse thinning. However, alopecia areata typically has sharply demarcated patches and lacks nail changes [2].
• Telogen effluvium: This condition is characterized by excessive shedding of hair due to an abnormality in the hair growth cycle. It often presents with a sudden increase in hair loss, but it can also be diffuse and non-scarring.
• Trichotillomania: This is a psychological disorder characterized by compulsive hair pulling or plucking. However, trichotillomania typically has a distinct pattern of hair loss, and the patient may exhibit other behavioral symptoms [11].
• Anagen effluvium: This condition is caused by damage to the hair follicle, leading to an abnormality in the growth cycle. It often presents with sudden and diffuse hair loss.
• Anaemia: In some cases, anaemia can cause hair loss due to a lack of essential nutrients for hair growth.

To confirm a diagnosis of LAHS, it is essential to perform a thorough physical examination, clinical history, and microscopic examination of the hairs [11]. A trichogram can also be instrumental in confirming the diagnosis [15].

In summary, the differential diagnosis of loose anagen hair syndrome includes alopecia areata, telogen effluvium, trichotillomania, anagen effluvium, and anaemia. A comprehensive diagnostic approach is necessary to rule out these conditions and confirm a diagnosis of LAHS.

References:

[2] - Context 2 [11] - Context 11 [15] - Context 15