They are usually organised in an orderly manner and densely compacted.Genetics is one of the causing factors of loose anagen syndrome. It has been studied that this hair condition is autosomal dominantly inherited. Diagnosis
Patients with loose anagen syndrome do not report the same hair abnormalities. Loose anagen syndrome is usually diagnosed after taking into consideration the physical examination, clinical history and a microscopic examination of the hairs of the patient. Some patients visit a dermatologist for diagnosis and to distinguish between loose anagen hair syndrome and other conditions that it can be misdiagnosed for.A pull test is performed in order to diagnose a patient with loose anagen hair syndrome as one of the characteristics of this hair condition is hair that is easily removed from the scalp. A group of around 40-60 hairs, that are attached to the scalp, is pulled in a clement manner. The patient will be diagnosed with loose anagen syndrome if great amounts of hair is detached from the head. If at least 50% of the hairs removed is at the anagen hair stage, the outcome of the pull test is positive. The detachment of only 4-6 hairs is considered a normal outcome, as approximately 10% of the hairs on the scalp are at the telogen stage. The removed loose anagen hairs are not fragile and are of normal tensile strength.In an electron microscope image of a loose anagen hair, deformities such as grooves, curls and ridges are visible in the hair shaft, which is made from keratin.
Many patients affected by loose anagen hair syndrome encounter spontaneous recovery by adulthood. The thickness and length of the hair of loose anagen syndrome patients have a tendency to improve and becomes more enhanced, especially post puberty. For some patients, improvement is observed from the ages of 8 or 9. There is still a defect in the connection of the hair shaft and inner root sheath, however it is not as severe and the hairs are not as easily detached as it was for these patients when they were young children. Patients can seek assistance and treatment can be pursued.The aims of treatment is to reduce the trauma being enacted on loose anagen hairs and to reassure loose anagen hair syndrome patients that over time there will be improvement in the cosmetics of their hair. Paediatricians, paediatric nurse practitioners and physician assistances are usually the first people to detect this hair condition in children. There are no surgical, physical or systemic medical treatment options for loose anagen syndrome.Patients with more severe cases of loose anagen hair syndrome can be treated with minoxidil, a topical medical treatment, as a first line treatment. Minoxidil can extend the duration of the hair in the anagen stage and restore the hair follicles for further growth or for the full period of the anagen phase. The hair of an individual without loose anagen hair syndrome is in the anagen hair phase for approximately 3 to 5 years.