By Gary M. White, MD

Loose anagen syndrome

Photograph courtesy of Eliot Mostow, MD

Loose anagen syndrome (LAS) is a disorder of abnormal anchorage of the hair. The shaft is normal, but the hairs may easily be pulled out.


The child has relatively sparse and short hair. It often does not extend below the neck. Hair on the nape may be easily knotted, giving rise to the term "bed head". There is no inflammation of the scalp. The parents may say the child's hair "just won't grow".

The hair may be removed (from the root) by gentle pulling. The hair itself is not fragile. Hair pull results in multiple hairs which on microscopic examination show anagen hairs. The roots of these hairs are surrounded by a sagging cuticle that resembles leg warmers.

Differential Diagnosis

Common considerations here include alopecia areata, trichotillomania and telogen effluvium.


Gentle hair care is of course recommended. The condition often improves over the years. Marked improvement of loose anagen syndrome was seen in 7/11 patients who used Minoxidil 5% lotion [AD 2002;138;501]. Biotin has been recommended, but there are no scientifically supported reports on the benefit of biotin for hair disorders.


Loose anagen hair syndrome: Is there any association with atopic dermatitis?. Indian Dermatol Online J 2016;7:56-7

Peds Derm 2016;33;507

Additional Pictures

Photograph courtesy of Eliot Mostow, MD
Loose anagen syndrome


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