Alopecia Flashcards
General Info
3 phases of hair cycle & what happens
- anagen (active growth)
- catagen (hair detaches)
- Telogen (follicles rest)
General Info
how many hairs do we lose each day normally?
100 to 200
General Info
important history questions
2
- is hair loss sudden or gradual?
- is hair loss focal or diffuse?
General Info
what does sudden hair loss indicate?
3 conditions
- alopecia areata
- telogen effluvium
- tinea capitis
General Info
what does gradual hair loss indicate?
2 conditions
- androgenetic alopecia
- trichotillomania
General Info
what does focal hair loss indicate?
4 things
- alopecia areata
- androgenetic alopecia
- tinea cavities
- trichotillomania
General Info
what does diffuse hair loss indicate?
4 things
- telogen effluvium
- alopecia universalis
- iron def anemia
- drug-induced hair loss
General Info
physical exam steps
5 things
- examine scalp for inflammation
- examine entire scalp by small parts throughout hair
- compare part width of the top of scalp w/ back of scalp
- note location & extent of thinning/loss
- perform hair pull/tug test
Androgenetic Alopecia
AKA
cicatrical baldness
Androgenetic Alopecia/Cicatrical Baldness
occurs in what % of men? by what age?
50% by 50
Androgenetic Alopecia/Cicatrical Baldness
occurs in what % of women? by what age?
50% by 80
Androgenetic Alopecia/Cicatrical Baldness
flow of hair loss seen in men?
- frontal hairline recedes
- bitemporal thinning
- thinning on top and crown
Androgenetic Alopecia/Cicatrical Baldness
hair loss seen in women?
where?
- thin on the top & sides
- retiain shape of hairline
Androgenetic Alopecia/Cicatrical Baldness
characterized by conversion of terminal hairs into what and then further into what?
- indeterminate
- vellus hairs
Androgenetic Alopecia/Cicatrical Baldness
tx
- topical minoxidil 5% daily foam
- PO finasteride or dutasteride QD
Androgenetic Alopecia/Cicatrical Baldness
how long until minoxidil makes impact?
6 to 12 mo
Telogen Effluvium
triggered by?
specificially what, then 4 examples
Major Stress
1. pregnancy
2. surgery
3. mental stresses
4. illnesses requiring hospitalization
Telogen Effluvium
why does it last longer for some people?
subtle changes to their hormone levels (meds)
Telogen Effluvium
how does it change the hair cycle?
makes it faster
Telogen Effluvium
what labs should be ordered if you suspect this?
6
- TSH
- T4
- CBC
- Iron Studies
- Vit D
- RPR
Telogen Effluvium
what is the most common treatable cause of hair shedding in women?
iron deficiency
Telogen Effluvium
tx
- reassurance
- tx of underlying issue that labs uncovers
Alopecia Areata
what attacks hair follicles?
lymphocytes
Alopecia Areata
associated most commonly with what other disease?
thyroid disease
Alopecia Areata
resolves w/out tx after how long?
6 mo
Alopecia Areata
how can re-growth hairs look?
thin or white
Alopecia Areata
what type of attack on body causes this?
i.e. is it pathogen, autoimmune, malignancy, genetic?
autoimmune
Alopecia Areata
where on body is this located?
any hair bearing part of body
Alopecia Areata
what labs to consider?
thyroid panel
Alopecia Areata
Tx
what 3 roues?
- intralesional injections
- Topical Steroids
- Topial Shampoo
Alopecia Areata
what to use for intralesional injfection?
med, dose, duration, freq
- Triamcinolone
- 2.5-10 mg/mL
- every 4 to 6 wks
Alopecia Areata
what to start w/ if treating w/ steroids?
potent or ultra potent steroids
betamethasone valerate 0.01% foam
betamethasone dipropionate 0.05% lotion
Alopecia Areata
what topical shampoo to use?
minoxidil 5% foam
Trichotillomania
Caused by what?
forceful pulling & removal of the hair
Trichotillomania
clinical presentation
- different lengths of hair w/in patch
- black dots from short hairs
- lack of scale or inflammation
Trichotillomania
tx
- screen for anxiety & depression
- Behavioral interventions
- SSRIs if indicated