By Ph. Adnan Mustafa Ismael

Life cycle of hair

By Ph. Adnan Mustafa Ismael 2 / 8 / 20131

Hair loss

2 / 8 / 2013

By Ph. Adnan Mustafa Ismael 2 / 8 / 2013 2

Hair loss affects both men and women.

Hair is classed as either terminal or vellus hair. Terminal hair is longer and thicker and found on the scalp and eyebrows. Vellus hair covers the remainder of the body and is shorter and downy. In androgenic alopecia terminal hair follicles transform in to more vellus-like hair follicles as a result of preferential binding by dihydrotestosterone (produced from the conversion of androgen by 5-alpha-reductase) to hair follicle receptors.

Clinical features androgenetic alopecia

1- Thinning of the hair.

2- Frontal receding hairline that might or might not be accompanied with hair loss at the crown.

Conditions to eliminate ( Not androgenic alopecia )

1- Pregnancy During pregnancy, circulating levels of oestrogen increase, with a resulting rise in the number of follicles in anagen (growth phase); the hair therefore thickens. However, after delivery the hair follicles return to the resting phase and the hair is shed. Women might believe that they are experiencing hair loss when in reality the hair is returning to the normal pre-pregnancy state.

2- Stress Stress is known to induce hair loss.

By Ph. Adnan Mustafa Ismael 2 / 8 / 2013 3

3- Nutritional factors Iron deficiency is associated with female hair loss. If iron deficiency is the cause, a 2-month course of iron supplementation should result in thickening of the hair.

4- Fungal scalp infection

The first signs of infection are the appearance of a well circumscribed round patch of alopecia that is associated with itch and scaling. Inspection of the area might reveal ‘black dots’ on the scalp as a result of infected hairs.

5- Traction alopecia نتيجة شد الشعر بقوة

Most commonly seen in women, traction alopecia refers to hair loss due to excess and sustained tension on the hair.

By Ph. Adnan Mustafa Ismael 2 / 8 / 2013 4

6- Medicine-induced causes

Cytotoxic medicines being one of the most obvious examples

7- Trichotillomania يحدث نتيجة قلع الشعر بصورة مستمرة إراديا او � اراديا

This refers to patients who have an impulsive desire to twist and pull scalp hair.

Treatment

1- Minoxidil (2% for female , 5% for male). المتوسطة من رغم نتائجهعتبر الع$ج آي

The dose for minoxidil is 1 mL applied to dry hair to the total affected areas of the scalp twice daily. Minoxidil therefore appears to delay and slow down hair loss in less than half of its target patient population. Hair counts appear to be greatest after 12 months of treatment but, by 30 months. If treatment is stopped any hair growth achieved is lost within 6 to 8 weeks on discontinuation of therapy and baldness returns to pretreatment levels.

By Ph. Adnan Mustafa Ismael 2 / 8 / 2013 5

If these occur the patient should stop using the product immediately chest pain, rapid heart beat, faintness or dizziness.

Side effect (common):

local irritation, redness and itching.

2- Finasteride لكن له اثار جانبية غير مقبولة نھائيا و يعطي ھذا الع$ج نتائج جيدة

Oral finasteride (1 mg per day) is used to treat androgenetic alopecia in men because it has shown to promote hair growth and prevent further loss in a significant proportion of men with male pattern baldness.

Side effect

Impotence, decreased libido, ejaculation disorders, and breast tenderness and enlargement.

References:

Community pharmacy 2nd edition, Paul rutter.