RT Book, Section
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
SR Print(0)
ID 1182455090
T1 Alopecia
T2 Pharmacotherapy: A Pathophysiologic Approach, 11e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260116816
LK accesspharmacy.mhmedical.com/content.aspx?aid=1182455090
RD 2024/04/25
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.