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Pharmacist Provided Care I > Hair Loss > Flashcards

Hair Loss Flashcards

1
Q

What is the only FDA approved OTC for hair loss?

A

Rogaine (minoxidil)

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2
Q

What class is Rogaine in?

A

Topical skin product

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3
Q

What is Rogaine indicated for?

A

Alopecia androgenetica in both males and females

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4
Q

What strengths and dosage forms is Rogaine available in?

A
  • 5% foam

* 2% and 5% solution

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5
Q

What is the dosing of Rogaine?

A

Apply bid

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6
Q

What are the warnings and contraindications of Rogaine?

A
  • do not use in children

* caution in patients with dermatologic disorders

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7
Q

What is the pregnancy class of Rogaine?

A

C

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8
Q

What are the interactions of Rogaine?

A

Limited due to topical use

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9
Q

What are the common side effects of using Rogaine?

A
  • May change hair color or texture
  • hypertrichosis
  • local reactions
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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
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11
Q

What percentage of men and women are affected at some point in their life by hair loss?

A

50%

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12
Q

What can hair loss be caused by?

A
  • hormonal changes
  • physiological stress
  • medications
  • illness
  • local trauma
  • dietary changes
  • combination of factors
  • genetics
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13
Q

What is alopecia?

A

loss of hair from the body

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14
Q

What can cause scarring alopecia?

A
  • discoid lupus
  • syphilis
  • tinea capitis
  • lichen plantus
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15
Q

What are the different types of non-scarring alopecia?

A
  • androgenetic alopecia
  • alopecia areata
  • anagen/telogen effluvium
  • trichotillomania
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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
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17
Q

What is alopecia areata?

A
  • rapid onset

* patchy hair loss

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18
Q

What is anagen/telogen effluvium?

A

Rapid shedding of growing and resting hairs

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19
Q

What is trichotillomania?

A

Compulsive pulling out of one’s hair

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20
Q

What are some other causes of hair loss?

A
  • malnutrition
  • medication use
  • chronic illness
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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
Q

What are the exclusions for self care of hair loss?

A
  • 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
Q

What are the two treatment goals of using hair loss medication?

A
  • restore patient’s previous appearance

* achieve an appearance considered acceptable to patient

27
Q

What are the two treatment options for hair loss?

A
  • pharmacologic

* non-pharmacologic

28
Q

What pharmacologic options are their for hair loss?

A
  • only one topical OTC option (Rogaine)

* if patient fails to see results with OTC option, refer patient to PCP

29
Q

What non-pharmacologic therapy is available?

A
  • camouflage (wigs, hair pieces, weaves, colorants, scalp camouflaging)
  • scalp massage
  • frequent shampooing
  • electrical stimulation
  • surgical transplantation of hair
30
Q

What is the mechanism of action of Rogaine?

A

Increases cutaneous blood flow to hair follicles

31
Q

When is Rogaine more effective?

A

If a smaller surface area of scalp is affected.

  • less than 1/4th in men
  • less than 1/3rd in women
32
Q

What is the onset of action of Rogaine?

A
  • 4 months for 2%

* 2 months for 5% (3 months in women)

33
Q

When should a patient stop Rogaine?

A

If there is no increased hair density seen at 4 months

34
Q

How should Rogaine be applied?

A

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
Q

How do you apply Rogaine solution?

A

Rub about 1 mL of product into affected area of scalp

36
Q

How do you apply Rogaine foam?

A
  • 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
Q

What are some side effects from using Rogaine?

A
  • 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
Q

What happens when you use Rogaine with guanethine?

A

orthostatic hypotension

39
Q

What happens when you use Rogaine with systemic minoxidil?

A
  • increased systemic levels

* enhance effects

40
Q

What happens when you use Rogaine with corticosteroids?

A

increased absorption and side effects

41
Q

What happens when you use Rogaine with petrolatum?

A

increased absorption and side effects

42
Q

What happens when you use Rogaine with retinoids?

A

increased absorption and side effects

43
Q

What age range is Rogaine most effective in? What symptoms?

A
  • young patients (18 to 65 years old)

* patient with limited hair loss

44
Q

What can Rogaine be used in combination with (Rx item)?

A

Finasteride 1mg–has better effects than either drug alone

45
Q

How long should a person wait to use Rogaine after applying a perm, hair color, or hair relaxant?

A

24 hours

46
Q

What type of patient has an increased risk for side effects?

A

Patients with psoriasis, severe sunburn, and damage to skin

47
Q

Who can use 2% and 5% Rogaine?

A

Both men and women. But, men should probably use 5%

48
Q

For sensitive skin, which dosage form of Rogaine is better?

A

Foam

49
Q

What should you consider when suggesting foam vs solution of Rogaine?

A
  • application preference
  • vision impairment
  • dexterity
50
Q

What other agents are marketed for hair growth?

A
  • 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

Pharmacist Provided Care I (8 decks)

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