A Girl Struggling With Extremely Unruly Hair

September 2014 in “ Journal of the American Academy of Dermatology ”

Christine Prodinger, Martin Laimer, Verena Ahlgrimm‐Siess

Loose anagen hair syndrome anagen hairs minoxidil trichomalacia anagen follicles Rogaine

TLDR The girl likely has Loose anagen hair syndrome, which may improve on its own or with minoxidil.

A 9-year-old girl with lusterless, unruly hair that seldom required cutting was examined, revealing matte, shaggy hair on a normal scalp without tooth or nail abnormalities. Her hair pull test was positive, showing a predominance of anagen hairs (>80%). The girl's brother had similar hair, while her sister had normal hair growth. The most likely diagnosis was Loose anagen hair syndrome. Histopathologic changes included empty anagen follicles with infundibular pigment casts, hemorrhage, and trichomalacia adjacent to unaffected hair follicles. Spontaneous improvement was common, and minoxidil therapy might hasten resolution.

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