Anagen Effluvium after Therapeutic Scalp Surgery: Unreported Phenomenon

Many procedures are performed on the scalp, such as excision of pilar and sebaceous cysts, melanocytic nevi, and reduction surgery for scarring alopecia, among others. In hair transplants, telogen effluvium is often reported 3 months after surgery; however, hair loss usually happens much earlier, around second week after the procedure, not compatible with the time required for hair to enter telogen and exogenous phases in normal conditions.

We report 3 cases of anagen hair loss 4 weeks after surgeries, with perilesional trichoscopy suggesting anagen effluvium, with typical signs such as black dots and exclamation hairs.

There are only a few reports about hair loss around operated areas. The cause of this postoperative anagen effluvium is probably a transient ischemia.

The practical importance of this phenomenon is to properly orient patients because most of the hair will be lost, since 85% of them are anagens, and also will have spontaneous recovery in the next 3 months.