Abstract This study concerns the behavior of the human follicle under stresses which cause temporary loss of hair. Many different agencies cause hair shedding.1 For some years now, I have been watching what happens to the follicle in a variety of natural and experimental alopecic conditions. Out of these observations has grown a biological generalization, the presentation of which is the main business of this essay. To grasp the meaning of this generalization, requires a thorough understanding of the hair cycle, and, in particular, catagen, that brief epoch during which a growing follicle (anagen) becomes transformed into a resting one (telogen). The prelude to the present theme is to be found in a previous paper dealing with the dynamics of human catagen.2 Further important readings are Montagna's3 analyses of hair cycle mechanics, and a recent study of catagen by Ellis and Moretti.4 The dynamics of change in References 1. I have deliberately chosen the word effluvium rather than defluvium because the former does not carry the connotation of sudden conspicuous hair loss of the latter. 2. Since submitting the manuscript I have seen another dramatic case of simultaneous loss of nails and hair which developed three months after an acute attack of anxiety. This was a woman who became very alarmed after breast surgery. 3. Van Scott, E. J.: Response of Hair Roots to Chemical and Physical Influence in Biology of Hair Growth , New York, Academic Press, Inc., 1958, pp. 441-449. 4. Kligman, A. M.: The Human Hair Cycle , J. Invest. Dermat. 33:307, 1957.Crossref 5. Montagna, W.: The Structure and Function of Skin , New York, Academic Press, Inc., 1958. 6. Ellis, R. A., and Moretti, G.: Vascular Patterns Associated with Catagen Hair Follicles in the Human Scalp , Ann. New York Acad. Sc. 83:448, 1959.Crossref 7. Butcher, E. O.: Restitutive Growth in the Hair Follicle of the Rat , Ann. New York Acad. Sc. 83:369, 1959.Crossref 8. Pinkus, H.: Embryology of Hair in Biology of Hair Growth , New York, Academic Press, Inc., 1958, pp. 1-32. 9. Van Scott, E. J.; Reinertson, R. P., and Steinmuller, R.: The Growing Hair Roots of the Human Scalp and Morphologic Changes Therein Following Amethopterin Therapy , J. Invest. Dermat. 29:197, 1957.Crossref 10. Galewsky, E.: Erkrankungen der Haare und des Haarbodens in Handbuch der Haut u. Geschlechtskrankheiten , Berlin, Springer-Verlag, 1932, Vol. 13, p. 221. 11. Pinkus, F.: Über den Haarausfall nach fieberhaften Krankheiten Med. Klin. Berlin , Urban & Schwarzenberg, 1906, Vol. 37, pp. 1-12. 12. Savill, A.: The Hair and Scalp , Baltimore, Williams & Wilkins Company, 1945. 13. Pinkus, F.: Einwirkung von Krankheiten auf das Kopfhaar des Menschen , Berlin, S. Karger, A.G., 1928. 14. Behrman, H. T.: The Scalp in Health and Disease , St. Louis, C. V. Mosby Company, 1952. 15. Lynfield, Y. L.: Effect of Pregnancy on the Human Hair Cycle , J. Invest. Dermat. , to be published. 16. Obermayer, M. E.: Psychocutaneous Medicine , Springfield, Ill., Charles C Thomas, Publisher, 1955. 17. Hirsch, F.: Das Haar des Menschen , Haug, Ulm-Donau, 1956. 18. Guy, W. B., and Edmundson, W. F.: Diffuse Cyclic Hair Loss in Women , A.M.A. Arch. Dermat. 81:205, 1960.Crossref 19. Crounse, R. C., and Van Scott, E. J.: Changes in the Scalp Hair Roots as a Measure of Toxicity from Cancer Chemotherapeutic Drugs , J. Invest. Dermat. , to be published. 20. Williams, C. D.: Kwashiorkor, Council on Foods and Nutrition , J.A.M.A. 153:1280 ( (Dec. 5) ) 1953.Crossref 21. Leider, M.: Practical Pediatric Dermatology , St. Louis, C. V. Mosby Company, 1956. 22. Perlman, H.: Pediatric Dermatology , Chicago, Year Book Publishers, Inc., 1960. 23. Flesch, P.: Hair Growth in Physiology and Biochemistry of the Skin , edited by S. Rothman, Chicago, University of Chicago Press, 1954, pp. 631. 24. Hamilton, J. B.: Patterned Loss of Hair in Man: Types and Incidence , Ann. New York Acad. Sc. 53:708, 1951.Crossref 25. Tedhope, G. R.; Cohen, H., and Meikle, R. W.: Alopecia Following Treatment with Dextran Sulfate and other Anticoagulant Drugs , Brit. M.J. 1:1034, 1958.Crossref 26. Hirschboeck, J. S.; Madison, F. W., and Pisciotta, W. V.: Alopecia and other Toxic Effects of Heparin and Synthetic Heparinoids , Am. J.M. Sc. 227:279, 1954.Crossref 27. Van Scott, E. J.: Evaluation of Disturbed Hair Growth in Alopecia Areata and Other Alopecias , Ann. New York Acad. Sc. 83:480, 1959.Crossref 28. Colsky, J.; Wallace, S., and Banowitch, M. M.: Treatment of Acute Gouty Arthritis with Demecolcine , A.M.A. Arch. Int. Med. 100:765, 1957.Crossref 29. Mikkelson, W. M.; Salin, R. W., and Duff, I. F.: Alopecia Totalis After Desacetylmethylcolchicine Therapy of Acute Gout , New England J. Med. 255:769, 1956.Crossref 30. Malkinson, F. D., and Lynfield, Y. L.: Colchicine Alopecia , J. Invest. Dermat. 33:371, 1959.Crossref 31. Myers, R. J., and Hamilton, J. B.: Regeneration and Rate of Growth of Hairs in Men , Ann. New York Acad. Sc. 53:562, 1951.Crossref 32. Pinkus, F.: Der Ausfall des Kopfhaars und seine Behandlung , Dermatologie und Syphilologie , Vol. 3, Pt. (1) , Halle o. S. 1924.
Archives of Dermatology – American Medical Association
Published: Feb 1, 1961
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