![]() ![]() Neither are licensed for or effective in treating alopecia areata, totalis or universalis. (The enzyme 5-alpha reductase is responsible for converting testosterone to DHT.) Finasteride is licensed for this indication and dutasteride is prescribed off-label. Male pattern baldness can be treated with 5-alpha reductase inhibitors, such as finasteride and dutasteride, or with minoxidil. ![]() This patient asking about Regaine for his eyebrows is likely to have alopecia universalis. Between 14 and 25 per cent of patients will progress to develop alopecia totalis or universalis. Up to 50 per cent of patients will recover from alopecia areata within a year, although many people experience more than one episode. Investigations are only required if it is necessary to distinguish between alopecia areata and fungal infections of the scalp. A careful history enables the GP to rule out trichotillomania, anagen effluvium and telogen effluvium as possibilities. In alopecia areata short, broken hairs (“exclamation mark hairs”) are often seen around the edges of the round bald patches. Both alopecia androgenetica and alopecia areata are normally diagnosed on the basis of a history and examination. Diagnosisĭiagnosis of alopecia androgenetica will often be made by the patient and confirmed by the GP. The condition has various triggers, including trauma, high fever, childbirth, surgery and some drugs. Hairs will be at different stages of the growth cycle and telogen effluvium occurs when larger than normal amounts of hair are in the telogen phase, resulting in them falling out at the same time and therefore widespread hairthinning. The hair usually begins to regrow if the drug is discontinued.ĭuring the telogen phase of hair growth, follicles are resting and hair is normally lost at a rate of about 50–100 hairs per day (often seen when brushing or washing the hair). In anagen effluvium hair loss can be rapid and some individuals lose all their hair. The anagen phase is the active phase of hair growth. This is a well known effect of cytotoxic drugs (eg, cyclophosphamide) and, more rarely, it is seen with heparin, warfarin, carbimazole and colchicine. Hair loss can be permanent if the traction is prolonged.Īnagen effluvium occurs when normal growth is abruptly halted. ![]() Traction alopecia is caused by continual tension on the hair due to hairstyle (eg, a tight ponytail or cornrows) or hair extensions. Alopecia androgenetica can lead to complete baldness but hair loss is usually confined to the scalp - eyebrows are unaffected. It is believed that DHT “strangles” hair follicles by reducing the blood supply so that the follicles become miniaturised and the individual hairs become thinner, less pigmented and eventually fall out. This inherited condition depends on dihydrotestosterone (DHT), a metabolite of testosterone. The most common type of hair loss is probably alopecia androgenetica. Alopecia universalis rarely resolves spontaneously. Alopecia totalis and alopecia universalis have also been linked to autoimmunity. Regrowing hair is sometimes white at first. The course, however, is unpredictable and symptoms can recur. In alopecia areata, spontaneous hair regrowth usually occurs after a few months. Trichotillomania (the habitual pulling out of hair) and dermatophyte scalp infection can also cause patchy hair loss. It is often associated with stress or emotional upheaval. The cause is unknown but it is thought to be an auto-immune condition. Other types of hair loss include traction alopecia, anagen effluvium and telogen effluvium.Īlopecia areata affects one or two people per 1,000 and is more common in the 15–29 year age group. Although this is often termed “male pattern baldness”, it can also affect post-menopausal women. Alopecia androgenetica describes a receding hairline and thinning of hair on the crown. Alopecia areata, for example, is associated with small, coin-shaped patches of baldness on the scalp, alopecia totalis describes complete loss of hair on the scalp and alopecia universalis describes the loss of all body hair. Alopecia is a general term for hair loss and there are different types. We do not recommend that you take any clinical decisions based on this information without first ensuring you have checked the latest guidance.Ī. Journal of Pharmaceutical Health Services Research.International Journal of Pharmacy Practice.Antimicrobial resistance and stewardship. ![]()
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