Hair Loss Flashcards
How many hair follicles do we have?
~125,000
How much hair do we lose per day?
40-100 hairs on non-shampoo day
200-300 hairs on shampoo day
True or false: the greatest genetic influence of hair loss comes from the paternal side
false
the maternal side
What are some situations that involve hair loss?
tinea capitis
anorexia
sever acute illnesses
alopecia areata
cancer chemo/radiation
What is alopecia areata?
autoimmune disorder that causes hair loss
Is there a preventative measure to hair loss from chemo?
no
often the key decision point for patients
When does chemo-induced hair loss start to show up?
1-3 weeks after first round
What are the many reasons for hair loss in women?
female-pattern baldness
menopause
stress
pregnancy
What is the hormonal impact on hair loss in women?
post-partum hair loss starts 1-3 months after delivery
hormones for menopause can aggravate hair loss
birth control pills (starting or stopping) can be a factor
What is the most common form of hair loss in women?
female-pattern baldness
-1/6 women
-vertex
-thinning is more gradual/subtle
What is androgenic alopecias?
male-pattern baldness
-most common form in men
-1/3 men
What is the etiology for androgenic alopecias?
DHT has a negative impact on hair
(remember testosterone is converted to DHT by a-reductase)
DHT is converted to estrogenic compounds by aromatase
-women have more aromatase, estrogenic compounds
nullifies DHT
What is the main treatment for hair loss?
Rogaine (minoxidil)
When is minoxidil used in men?
AGA only
best if hair growth needed on crown
-new hairs are bably-like
best in patients <40
best if starting with small area
What are some things to make patients aware of with minoxidil?
need to use it for a minimum of 2-4 months
needs continuous application
discontinuation results in new hair lost within 3 months
stop trying after 8-12 months if no results are seen
What are the side effects of minoxidil?
almost none, generally well tolerated
maybe some scalp irritation
small chance of cardiovascular effects
True or false: a patient with psoriasis can use minoxidil
false
must have a healthy scalp
How do you use minoxidil solution?
apply 1ml BID to dry scalp
-pump spray: 6 sprays=1ml
-1ml dropper
needs 4hrs of contact, dont shower
What is something that you must make patients aware of with minoxidil?
increase in hair loss during the first 2-6 weeks
What is the mechanism of action of finasteride?
type II alpha reductase inhibitor
-prevents conversion of testosterone to DHT
-DHT has harmful impact on hair
In which group is finasteride contraindicated in?
pregnant women
-has been tried in women if minoxidil fails, contraception is a
must
Which strength of finasteride is used for androgenic alopecia in men?
1mg (Propecia)
5mg is for BPH (Proscar)
Describe the effectiveness of finasteride in hair loss.
growth mainly seen on crown
growth occurs within 3 months
requires continuous use
can slow loss
What are the side effects of finasteride?
decreased libido (2-3% of men)
What is hirustism?
excessive terminal hair in a male-pattern distribution in women
potential sign of PCOS
What is the difference between mens and womens Rogaine?
they are the same product, just different dosing
-men are BID
-women are OD
What are the forms of Rogaine for men?
2% solution or 5% foam
-5% is likely better than 2%
What are the forms of Rogaine available for women?
5% foam
-1/2 capful OD
