Hair Flashcards
What is anagen hair?
Growing phase cycle. 1-5 years.
What is telogen hair?
Resting phase cycle. 3 months.
In utero, babies molt both body hair and scalp hair twice…when?
22 weeks and 28 weeks
Occipital hair loss in a baby is due to what?
Loose hair from the molt is lost
T or F. Male hair grows faster than female hair.
F: it takes longer to grow a masterpiece.
T or F. Hair grows faster when the sun isn’t shining.
F: grows faster in the summer than winter.
What is the medical term for common baldness?
Androgenic Alopecia…so the common folk won’t know what we’re talking about.
What happens in androgenic alopecia?
Gradual miniaturization of hairs with transformation of large terminal follices to small vellus follicles which are invisible. Process is androgen dependent (dihydrotestosterone).
What is the pattern of androgenic alopecia in men?
Frontotemporal recession, vertex thinning, and loss of all scalp hair except occipital fringe. Visible in mirror early.
What is the pattern of androgenic alopecia in women?
Retain frontal hairlines but have decreased density on their crowns. When ya ladies gettin ya hurrr did, ya girl holla at ya and be like you’s losin that hurrrr girl.
What is the average age onset of baldness in women?
25-35 years old (about a decade later than males)
Female presents with alopecia but in a male type pattern. What do you do?
Check DHEAS and testosterone levels
What is the inheritance mode of androgenic alopecia?
Autosomal dominant or multifactorial inheritance
What is the treatment for androgenic alopecia?
-Minoxidil (Rogaine) -Finasteride (Propecia): antiandrogen -Hair transplant
What does topical minoxidil do?
Increases hair density either by induction of anagen or an increase in anagen duration. Also increases hair diameter.
Which % of minoxidil do you give men? Women?
2% or 5% to men…5% shown to work better. Only give 2% to women because they can’t handle that 5% juice.
What is the MOA of Finasteride (Propecia)?
Inhibits Type II 5 alpha reductase which converts androgen testosterone into 5 alpha dihydrotestosterone. Propecia mainly stops the progression of hair loss.
What is the most concerning side effect of Propecia?
Sexual dyscrasia. Sexual side effects can even last after the pt stops taking the drug.
How many hairs are normally shed from the scalp in one day?
100
What is Telogen Effluvium?
An excess shed of telogen hair occurs due to a premature shunting of anagen to telogen in response to a precipitating cause. Since telogen lasts 3 months, when this is lost it is perceived as hair loss.
What are the common precipitating causes of telogen effluvium?
Childbirth/postpartum period, febrile episodes, surgery, drugs, endocrinopathies, nutritional-metabolic disorders (crash diet), autoimmune dz, physical trauma (MVA), infxns, emotional trauma
How long after a precipitating cause is telogen effluvium observed?
6 weeks to 3 months post-insult
What is the usual outcome of telogen effluvium?
Hair regrows normally in 6-12 months unless the precipitating cause is repeated or persists.
What is the treatment of telogen effluvium?
Telling your patient that everything is gonna be rainbows and skittles. If that doesn’t work, throw a little 2% minoxidil on it.
What is anagen effluvium?
An acute and extreme alteration of growth of majority of anagen hair resulting in 80-90% loss of scalp hair.
What are precipitating causes of anagen effluvium?
Chemotherapy drugs, thallium, mercury, anticoagulants
How long after a precipitating cause is anagen effluvium observed?
1-2 weeks post-insult
Drug alopecia usually presents as what type of effluvium?
Telogen effluvium
***PAY ATTENTION*** Circular areas of complete loss of hair with normal scalp?
Alopecia areata
T or F. Alopecia areata is immunologically mediated and also results in pitting of the nails.
T
How do you dx alopecia areata?
Look at it
Bx of alopecia areata shows what?
Lymphocytes around hair bulb referred to as “swarm of bees.”
Which hairs does alopecia areata usually affect?
Pigmented terminal hairs
In alopecia areata, how may hair grow back?
White and change to curly or straight
What is the usual outcome of alopecia areata?
90% regrow hair without tx. The dz progress may be slow or fast. And hair regrowth may be immediate or take weeks to years.
What is the tx for alopecia areata?
Topical steroids, interlesional steroids, anthralin, topical minoxidil, immunotherapy
What is traction alopecia?
Loss of hair associated with use of rollers, hot combs, hair weaving, platting, and perms.
What is characteristic of traction alopecia?
Peripheral fringe
What can traction alopecia result in?
Staph aureus folliculitis or fungal infxn
What is the tx for traction alopecia?
Alleviate further injury and encourage pt to have a short natural hairstyle
What is folliculitis?
Inflammation of the opening of the hair follicles with bacterial or fungal infxn.
What is the primary lesion of folliculitis?
Perifollicular pustule
What are some causes of folliculitis?
Chemicals (mineral oil), physical trauma (scratching), friction from headbands or hats. Conditioners may be the leading cause of scalp folliculitis.
What is the most common bacterial cause of folliculitis?
Staph aureus; shown here is dissecting folliculitis/cellulitis
What is the tx for folliculitis?
Oral abx (consider MRSA) and medicated shampoos
What kind of hair loss pattern does a syphilis pt exhibit?
Moth-eaten appearance. Will also be RPR+. Treat for syphilis and pt will regrow hair.
What do you do when a pt complains of hair loss?
- Check scalp for skin/scalp dz that causes hair loss 2. CBC (anemia) 3. Ferritin: normal CBC but low ferritin…tx with iron and hair regrows 4. TSH for hypo- and hyperthyroidism
