A cross-sectional examination of a loose anagen hair displays irregularity such as the shape of the hair being triangular rather than oval. The electron microscopy scanned image of the inner root sheath of a loose anagen hair would exhibit ultrastructural changes. These changes are visible in the Huxley layer, Henle layer and the cuticle of the loose anagen hair. An electron microscopy image of outer root sheath of an loose anagen hair would display malformations and weak linkage in the cells within the epithelium of the outer root sheath. This irregularity within the outer root sheath of a loose anagen hair is considered the most notable change when examining a loose anagen hair under an electron microscope.In a histopathological examination, the different layers of the loose anagen hair follicle will display a deficiency of clarity between the layers. This incoherence is also visible in a histological slide of the inner root sheath and of the outer root sheath.Biopsies are not necessary for the diagnosis of loose anagen hair syndrome. A biopsy will display non-inflammatory, non-scarring alopecia.The texture of the hair varies with some reports stating that patients with loose anagen syndrome have hairs that are rough, brittle and sticky. This may be the result of the deformations of the hair shaft. These changes in texture limits the ability for adjacent loose anagen hairs to rest flat on the scalp. The patient can have thinning and loss of hair around the whole scalp, at the occipital scalp or around the scalp in odd, irregular patches.
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.