{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T17:31:33Z","timestamp":1792517493701,"version":"4.5.0"},"reference-count":159,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T00:00:00Z","timestamp":1674432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The hair cycle is composed of four primary phases: anagen, catagen, telogen, and exogen. Anagen is a highly mitotic phase characterized by the production of a hair shaft from the hair follicle, whereas catagen and telogen describe regression and the resting phase of the follicle, respectively, ultimately resulting in hair shedding. While 9% of hair follicles reside in telogen at any time, a variety of factors promote anagen to telogen transition, including inflammation, hormones, stress, nutritional deficiency, poor sleep quality, and cellular division inhibiting medication. Conversely, increased blood flow, direct stimulation of the hair follicle, and growth factors promote telogen to anagen transition and subsequent hair growth. This review seeks to comprehensively describe the hair cycle, anagen and telogen balance, factors that promote anagen to telogen transition and vice versa, and the clinical utility of a variety of lab testing and evaluations. Ultimately, a variety of factors impact the hair cycle, necessitating a holistic approach to hair loss.<\/jats:p>","DOI":"10.3390\/jcm12030893","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T04:50:41Z","timestamp":1674449441000},"page":"893","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":165,"title":["Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0338-5607","authenticated-orcid":false,"given":"Nicole","family":"Natarelli","sequence":"first","affiliation":[{"name":"Morsani College of Medicine, University of South Florida, Tampa, FL 33602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimrit","family":"Gahoonia","sequence":"additional","affiliation":[{"name":"College of Osteopathic Medicine, Touro University, 1310 Club Dr, Vallejo, CA 94592, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7205-8162","authenticated-orcid":false,"given":"Raja K.","family":"Sivamani","sequence":"additional","affiliation":[{"name":"College of Medicine, California Northstate University, 9700 W Taron Dr, Elk Grove, CA 95757, USA"},{"name":"Integrative Skin Science and Research, 1495 River Park Drive, Sacramento, CA 95819, USA"},{"name":"Pacific Skin Institute, 1495 River Park Dr Suite 200, Sacramento, CA 95815, USA"},{"name":"Department of Dermatology, University of California-Davis, 3301 C St #1400, Sacramento, CA 95816, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1056\/NEJM199908123410706","article-title":"The Biology of Hair Follicles","volume":"341","author":"Paus","year":"1999","journal-title":"N. 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