Hair loss

Question 1

What are the factors that predisposes a patient to hair loss?

Answer 1

1. Age (Male > 30yo, Female after menopause)
2. Hormone changes
3. Hereditary/family history

Question 2

Type of hair loss that is suitable for self-care

Answer 2

Androgenic alopecia

Question 3

First-line OTC treatment option for androgenic alopecia?

Answer 3

Minoxidil 2% scalp solution

(Minoxidil 5% also have, but may cause more dermatitis, and not more effective than 2% in women)

Question 4

Counselling points for minoxidil hair solution

Answer 4

• Use 1 mL BD on completely dry hair and scalp
• Absorbed over 4h, hence apply 4h before showering/bedtime
• Takes at least 4 months before improvement is seen
• If no improvement after 1 year (8 mo for females), see doctor
• If stopped, grown hair fall out over 6-8w and return to pre-treatment baldness

Question 5

Side-effects of minoxidil solution, especially for 5% solutions?

Answer 5

• Hypertension: caution in people with HTN
• Burning and/or stinging sensation
• Contact dermatitis

Question 6

Can minoxidil be used in breastfeeding or pregnant individuals?

Answer 6

No

Question 7

Non-pharmacological counselling for androgenic alopecia

Answer 7

• Wigs if severe
• Avoid oily hair products –> Can cause folliculitis
• Avoid hair styles that pull the hair (e.g. braids)
• Have a well-balanced diet

Question 8

MoA of minoxidil

Answer 8

Hair growth secondary to vasodilation due to increased blood flow