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AlopeciaAlopecia
Nastaran tavakoliNastaran tavakoliGuilan University of Medical sciencesGuilan University of Medical sciences
Anatomy of HairAnatomy of Hair
• Launugo
• Vellus hair
• Terminal hair
• The life cycle of a hair is divided into three phases.
• The actively growing (Anagen)phase• the transitional(Catagen) phase• the resting (Telogen) phase.
Hair Growth CycleHair Growth Cycle
Hair pull testHair pull test
TrichogramTrichogram
Anagen Catagen
Telogen
• A physiologic reaction• Genetic• DHEA-S• Norwood-Hamilton Classification• Family history: Commonly positive
Androgenic Alopecia in menAndrogenic Alopecia in men(male pattern baldness)(male pattern baldness)
Norwood-Hamilton Norwood-Hamilton ClassificationClassification
TreatmentTreatment
• Minoxidil(Rogaine)• Finasteride(Propecia)• Autotransplantation of hair• flap surgery• Scalp extension and expansion
Androgenic Alopecia in WomenAndrogenic Alopecia in Women(Female pattern hair loss)(Female pattern hair loss)
• Women with androgenetic alopecia do not have higher levels of circulating androgens.
• Normal menses• Normal fertility• Diffuse central thinning• There is not usually any recession of
the frontal hairline.
• Associated findings: Signs or symptoms of hyperandrogenism should be looked for, ie, hirsutism,moderate to severe or treatment-refractory acne,irregular menses, infertility, and/or galactorrhea.Acanthosis nigricans is a marker for insulin resistance which is commonly associated with hyperandrogenism
• If a woman has irregular menses, abrupt hair loss, hirsutism, or acne recurrence, an endocrine evaluation is appropriate.
• In this situation, total testosterone, free testosterone, dehydroepiandrosterone sulfate,and prolactin levels should be obtained.
• Check TSH and serum ferritin• Hypothyroidism• iron deficiency (serum ferritin or serum iron
and TIBC)
• telogen effluvium
• Minoxidil• Finasteride?• Spironolactone (Aldactone)• Cyproterone Acetate with
Ethinyloestradiol (Diane )
TREATMENT:
Traction alopeciaTraction alopecia• This condition is caused by localized
trauma to the hair follicles from tight hairstyles that pull at hair over time.
• If the condition is detected early enough, the hair will regrow.
• Braiding, cornrows, tight ponytails, and extensions are the most common styling causes.