Hair Loss Flashcards
1
Q
What is the only FDA approved OTC for hair loss?
A
Rogaine (minoxidil)
2
Q
What class is Rogaine in?
A
Topical skin product
3
Q
What is Rogaine indicated for?
A
Alopecia androgenetica in both males and females
4
Q
What strengths and dosage forms is Rogaine available in?
A
- 5% foam
* 2% and 5% solution
5
Q
What is the dosing of Rogaine?
A
Apply bid
6
Q
What are the warnings and contraindications of Rogaine?
A
- do not use in children
* caution in patients with dermatologic disorders
7
Q
What is the pregnancy class of Rogaine?
A
C
8
Q
What are the interactions of Rogaine?
A
Limited due to topical use
9
Q
What are the common side effects of using Rogaine?
A
- May change hair color or texture
- hypertrichosis
- local reactions
10
Q
What other information should you know about Rogaine?
A
- may take 4 months to see growth with 2%
- may take 2 to 3 months for 5%
- once product is discontinued, hair loss will return to what it was before product was started
11
Q
What percentage of men and women are affected at some point in their life by hair loss?
A
50%
12
Q
What can hair loss be caused by?
A
- hormonal changes
- physiological stress
- medications
- illness
- local trauma
- dietary changes
- combination of factors
- genetics
13
Q
What is alopecia?
A
loss of hair from the body
14
Q
What can cause scarring alopecia?
A
- discoid lupus
- syphilis
- tinea capitis
- lichen plantus
15
Q
What are the different types of non-scarring alopecia?
A
- androgenetic alopecia
- alopecia areata
- anagen/telogen effluvium
- trichotillomania
16
Q
What is androgenetic alopecia (AGA)?
A
- Pattern hereditary hair loss
- slow, gradual process
- thinning usually occurs at the top rear of the head (vertex), frontal hairline and occipital regions
17
Q
What is alopecia areata?
A
- rapid onset
* patchy hair loss
18
Q
What is anagen/telogen effluvium?
A
Rapid shedding of growing and resting hairs
19
Q
What is trichotillomania?
A
Compulsive pulling out of one’s hair
20
Q
What are some other causes of hair loss?
A
- malnutrition
- medication use
- chronic illness
21
Q
What type of treatment should you give for AGA?
A
- it does NOT need a medical referral
* can be treated with self care
22
Q
What is the most common form of hair loss?
A
AGA
23
Q
In what ethnicity is AGA most common in? What gender?
A
- caucasian
* males
24
Q
Describe typical hair loss in women.
A
- typically more diffuse
- tends to be thin, short, and tapered
- more genetic than androgenic
25
What are the exclusions for self care of hair loss?
* less than 18 years old
* pregnancy or breast feeding
* recent discontinuation of oral contraceptives
* no family history of hair loss
* positive hair pull test
* history of endocrine dysfunction, medical treatments (chemo), dietary deficiencies
* sudden or patchy hair loss
* evidence of fever or inflammation 3 to 6 months before hair loss begins
* skin lesions that indicate auto-immune disease or infections
* scaling, sunburn, or other damage to scalp
* broken off hair shafts that resemble those caused by fungal infection or trichotillomania
* loss of eyebrows or eyelashes
* changes in nails
* women with sudden or severe hair loss
* postpartum women with hair loss
26
What are the two treatment goals of using hair loss medication?
* restore patient's previous appearance
| * achieve an appearance considered acceptable to patient
27
What are the two treatment options for hair loss?
* pharmacologic
| * non-pharmacologic
28
What pharmacologic options are their for hair loss?
* only one topical OTC option (Rogaine)
| * if patient fails to see results with OTC option, refer patient to PCP
29
What non-pharmacologic therapy is available?
* camouflage (wigs, hair pieces, weaves, colorants, scalp camouflaging)
* scalp massage
* frequent shampooing
* electrical stimulation
* surgical transplantation of hair
30
What is the mechanism of action of Rogaine?
Increases cutaneous blood flow to hair follicles
31
When is Rogaine more effective?
If a smaller surface area of scalp is affected.
* less than 1/4th in men
* less than 1/3rd in women
32
What is the onset of action of Rogaine?
* 4 months for 2%
| * 2 months for 5% (3 months in women)
33
When should a patient stop Rogaine?
If there is no increased hair density seen at 4 months
34
How should Rogaine be applied?
Apply bid to clean, dry scalp and hair
*allow 2 to 4 hours for the drug to penetrate scalp
*at night, apply 2 to 4 hours before bedtime
(apply 5% once daily in women)
*wash hands after application
*don't double the dose if application is missed
*don't use a hair dryer after applying
*product must be dry before lying down or applying other products
35
How do you apply Rogaine solution?
Rub about 1 mL of product into affected area of scalp
36
How do you apply Rogaine foam?
* wash hands in cold water before applying (so you don't melt the foam)
* part hair into one or more rows
* hold can upside down and apply 1/2 of a capful of foam to fingertips
* use fingertips to spread the foam over thinning area and then massage gently into area
37
What are some side effects from using Rogaine?
* local itching and irritation at the site of application
* most common with long term use is transient hypertrichosis
* rarely, there is acne at the application site, increased hair loss, inflammation of hair root, red skin, swelling of face, and allergic dermatitis
* systemic (rare): low BP, blurred vision, HA, weight gain, flushing, swollen hands and feet, numbness of face, hand and feet, irregular heart rate
38
What happens when you use Rogaine with guanethine?
orthostatic hypotension
39
What happens when you use Rogaine with systemic minoxidil?
* increased systemic levels
| * enhance effects
40
What happens when you use Rogaine with corticosteroids?
increased absorption and side effects
41
What happens when you use Rogaine with petrolatum?
increased absorption and side effects
42
What happens when you use Rogaine with retinoids?
increased absorption and side effects
43
What age range is Rogaine most effective in? What symptoms?
* young patients (18 to 65 years old)
| * patient with limited hair loss
44
What can Rogaine be used in combination with (Rx item)?
Finasteride 1mg--has better effects than either drug alone
45
How long should a person wait to use Rogaine after applying a perm, hair color, or hair relaxant?
24 hours
46
What type of patient has an increased risk for side effects?
Patients with psoriasis, severe sunburn, and damage to skin
47
Who can use 2% and 5% Rogaine?
Both men and women. But, men should probably use 5%
48
For sensitive skin, which dosage form of Rogaine is better?
Foam
49
What should you consider when suggesting foam vs solution of Rogaine?
* application preference
* vision impairment
* dexterity
50
What other agents are marketed for hair growth?
* amino acids
* aminobenzoic acid
* B vitamins (B7-biotin is common)
* jojoba oil
* lanolin
* maidenhair fern
* polysorbates 20 and 660
* royal jelly
* tetracaine hcl
* urea
* wheat germ oil
