Chemotherapy-induced anagen effluvium

What is anagen effluvium?

Anagen effluvium is a type of non-scarring alopecia and a common consequence of many oncological treatments. It occurs because hair follicle cells in the growth (anagen) phase have a high rate of division and are particularly sensitive to chemotherapeutic agents. 

Signs and symptoms of anagen effluvium

It occurs as rapid, massive and generalised hair loss, which typically begins a few weeks after the onset of chemotherapy. Hair loss may be abrupt and affect other body hair, for example, the eyebrows and eyelashes, which can have a significant emotional impact on the patient. 

Although its appearance can be alarming, in the vast majority of cases, the process is reversible, with progressive hair regrowth after completion of the treatment. Generally, this occurs within 3-6 months, although the rate and initial characteristics of regrowth may vary. 

Causes of anagen effluvium 

Key risk factors include the type of chemotherapy used, the cumulative dose and treatment cycle intensity. As a preventive measure, scalp cooling systems (cold caps) may reduce drug delivery to the follicle by decreasing local blood flow and, in some cases, lessen or delay hair loss. However, their effectiveness depends on the treatment regimen and they may not be suitable for all patients. 

Treatment of anagen effluvium

Treatment focuses on emotional support, cosmetic measures and, in some cases, the use of medication to accelerate the regrowth phase.