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21 Cards in this Set
- Front
- Back
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stages of hair follicle growth |
aganen phase (active) catagen phase (transitional) telogen phase (resting) |
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vellus hair |
-fine hair -covers most of the body |
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terminal hair |
-dark, pigmented, longer, coarser hair -located on scalp, face, armpits, pubic area at puberty |
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drugs associated with hair loss |
-hormones (eg oral contraceptives) -thyroid-related meds (eg levothyroxine, methimazole, propylthiouracil) -antidepressants -isotretinoin and excessive consumption of Vit. A -colchicine - disrupts mitosis -antineoplastics - abruptly stop active hair growth |
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androgenic alopecia |
male and female-pattern baldness (hair loss that is symmetrical) -most cases of accelerated hair loss -for males, generally begins at puberty up to 40 year of age -genetic predisposition male > female (females post-menopause)
-reduced ratio of scalp hairs in anagen:telogen phases from 14:1 to 5:1 |
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dihydrotestosterone (DHT) |
-the most potent androgen -testosterone metabolite produced by 5-alpha reductase -responsible for secondary sex characteristics -causes susceptible follicles on head to decrease in size producing finer hairs that cover scalp poorly |
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non-pharm therapy |
hair prostheses low-level laser therapy "comb-over" technique "spray-on" hair, scalp darkening agents hair transplantation (most effective but most invasive) |
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pharm therapy |
-arnica -saw palmetto -topical henna -nutrtional supplements (zinc, Vit B complexes, biotin, folic acid, lysine and other amino acids) -azelaic acid -ketoconazole 2% q2-4d -topical latanoprost 0.1% -finasteride -antiandrogens (women) -minoxidil |
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Finasteride |
Rx only
1mg daily
-5-alpha reductase inhibitor -indicated for men (sometimes used in women) -effective for men (no comparative studies w minoxidil) -reduced libido |
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antiandrogens |
women
progesterone spironolactone cyproterone topical estradiol valerate |
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Minoxidil |
the only non-Rx treatment with proven efficacy in treating all alopecia except age-related |
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Minoxidil products and dose |
2% soln 5% foam
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minoxidil soln administration |
2% or 5% propylene glycol-base
1mL application bid onto dry scalp with finger
must allow to dry before bedtime to prevent loss of medicine on sheets and pillow (5 hours before) |
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minoxidil foam administration |
5% (no propylene glycol)
1/2 capful bid massaged into dry scal
must allow to dry before bed
more aesthetically pleasing and dries more quickly than soln |
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Minoxidil MOA |
not well understood
possibly: -stimulation and prolongation of anagen phase -vasodilation increases cutaneous blood flow -opens potassium channels? prostaglandin production?
does not have antiandrogenic effect |
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minoxidil effects |
increases hair shaft diameter increases hair count and hair weight
benefits last for as long as pt is using minoxidil all benefits are completely lost within 6mth of stopping therapy |
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Minoxidil in women |
in 1 year study:
statistically increases hair count increase hair density and pattern provides moderate scalp coverage and satisfaction
quality of life remains unchanged
-no significant difference in efficacy of 2% vs 5% (more SEs w 5%) |
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Minoxidil in men |
in short-run: -provides moderate hair growth and scalp coverage -significantly increase hair count over placebo
in long-run -patient dissatisfaction -SEs -lack of compliance
5% statistically and clinically more effective than 2% (but not VASTLY more effective) |
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Minoxidil SE |
dose-related -allergic dermatitis -mild headache (w 5% strength) -temporary shedding at 10-12 wk -unwanted facial hair (sideburns, chin, upper lip, cheeks, forehead) in some women
propylene glycol, ethanol -skin irritation, dryness, flaking, itchiness -greasy and matted-looking hair |
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Minoxidil drug interactions |
diuretics antihypertensives = potentiated hypotension |
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Minoxidil precaution |
coronary artery disease angina CHF severe renal dysfunction |
