TY - CHAP M1 - Book, Section TI - Alopecia A1 - Law, Rebecca M. A1 - Do, Le Hanh Dung A1 - Maibach, Howard I. A2 - DiPiro, Joseph T. A2 - Yee, Gary C. A2 - Posey, L. Michael A2 - Haines, Stuart T. A2 - Nolin, Thomas D. A2 - Ellingrod, Vicki PY - 2020 T2 - Pharmacotherapy: A Pathophysiologic Approach, 11e AB - KEY CONCEPTSThe hair cycle consists of three phases: anagen, catagen, and telogen. These are not synchronized across all hair follicles. Different factors regulate each phase of the hair cycle.Pattern hair loss (or androgenetic alopecia) is an inherited condition in which androgens play a key role.Inflammation plays an important role in alopecia. Inflammatory infiltrates are evident in androgenetic alopecia and alopecia areata. Alopecia areata is the most frequent cause of inflammation-induced alopecia. Chronic inflammation may lead to the destruction of the hair follicle, resulting in irreversible hair loss.Scarring hair loss (or cicatricial alopecia) leading to irreversible hair loss can be caused by chronic inflammation or secondary to burns, cancer, trauma, radiation, or other diseases such as lichen planopilaris and chronic cutaneous lupus erythematosus.Thinning of hair or hair loss is usually the only clinical sign of alopecia. Other symptoms (eg, itching, pain, burning, or prickly discomfort) would suggest other underlying disease conditions. Dermatologic diseases can cause hair loss, which varies from mild, nonscarring, and reversible to scarring and irreversible.Alopecia can be distressing, affecting the quality of life and causing psychological problems. Psychosocial support and counseling must not be overlooked.Treatment and management strategies of alopecia should be as cause-specific as possible. Identified causes (eg, iron deficiency, tinea capitis) should be treated and/or eliminated as soon as practically feasible.Treatment for androgenetic alopecia includes topical minoxidil, oral 5α-reductase inhibitors (finasteride, dutasteride) for men, hormonal therapy for women, and miscellaneous therapies including nutritional supplements and laser light therapy with variable efficacy.Treatment for alopecia areata includes intralesional corticosteroids, topical corticosteroids, high-dose oral corticosteroids, topical minoxidil, topical immunotherapy, topical and systemic biologic agents (in particular JAK inhibitors), azathioprine and other immunosuppressive agents, and other miscellaneous therapies. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1182455090 ER -