Androgenetic Alopecia (Final)

Question 1

this is also known as male/female-pattern hair loss or baldness; androgen-induced hair loss that is hereditary

Answer 1

androgenetic alopecia

Question 2

does this happen in men or women with androgenetic alopecia: hair thinning starts at the crown, gradually progressing to the mid-scalp area

Answer 2

men

Question 3

does this happen in men or women with androgenetic alopecia: hair loss is milder presenting as a central thinning or widening of the part line

Answer 3

women

Question 4

this phase of the normal physiology of hair growth is also known as the growth phase

Answer 4

anagen phase

Question 5

this phase of the normal physiology of hair growth is also known as the transformation phase; usually lasts 2-3 weeks where the hair follicle moves upwards and separates from blood supply

Answer 5

catagen phase

Question 6

this phase of the normal physiology of hair growth is also known as the resting phase; usually lasts 2-3 months; at the end of this phase the hair is releases from the scalp

Answer 6

telogen phase

Question 7

which of the 3 phases of the normal physiology of hair growth I shortened in androgenetic alopecia

Answer 7

anagen phase

Question 8

how does testosterone play a part in androgenetic alopecia

Answer 8

testosterone gets converted to DHT by 5-alpha reductase. DHT binds to an androgen receptor forming an androgen-receptor complex. this activates genes responsible for transformation of large follicles to smaller follicles with a shortened anagen phase

Question 9

true or false: individuals with androgenetic alopecia appear to have relatively higher levels of 5-alpha reductase and androgenic receptors

Answer 9

true

Question 10

if a patients has:
- hair thinning on crown (in males)
- widening of part (in females)
- family history of similar hair loss
what are the first line tx options for this possible androgenic alopecia

Answer 10

• nonpharmacologic options (cosmetic hair products, hair extensions)
• topical minoxidil

Question 11

what are the goals of therapy regarding treating androgenetic alopecia

Answer 11

• decrease rate of hair thinning and increase coverage in areas of hair loss
• manage psychological factors (self esteem, mood changes, etc.)

Question 12

what are some non-pharm tx options for androgenetic alopecia

Answer 12

• healthy hair habits (avoid chemical treatments, avoid excessive brushing, minimize heat)
• hair extensions, wigs, hair pieces
• camouflaging agents

Question 13

this pharmacological treatment is usually first line if non-pharm measures do not suffice. it is shown to be effective for both male and female-pattern hair loss. this medication prolongs the duration of the anagen phase, increasing hair count and weight

Answer 13

topical minoxidil

Question 14

this minoxidil formulation is approved for male pattern hair loss only

Answer 14

solution (2%)

Question 15

this minoxidil formulation is approved for both male and female pattern hair loss

Answer 15

foam (5%)

Question 16

true or false: minoxidil can be compounded as a 5% solution in 70% ethyl alcohol (Biobase)

Answer 16

true -> cheaper and less irritating to the scalp

Question 17

what are the administration counselling points for minoxidil

Answer 17

• apply directly to a DRY scalp
• avoid direct application to the hair
• wash hands after application
• product should stay in place for at least 4 hours for maximum efficacy

Question 18

should minoxidil solution be applied OD or BID

Answer 18

BID

Question 19

should minoxidil foam be applied OD or BID

Answer 19

men: BID
women: OD

Question 20

when should patients expect to see hair growth if using topical minoxidil

Answer 20

2 months; max effect within 1 year

Question 21

true or false: patients may see hair shedding during the first 1-2 months of using minoxidil

Answer 21

true

Question 22

what are some adverse effects patients should monitor for when using topical minoxidil

Answer 22

• contact dermatitis
• tachycardia and hypertension (rare)

Question 23

this is a pharmacological option for androgenetic alopecia. it is a competitive inhibitor of 5a-reductase, therefore it reduces scalp DHT levels

Answer 23

finasteride

Question 24

what strength of finasteride is used to treat androgenetic alopecia

Answer 24

finasteride 1mg

Question 25

true or false: Finasteride is primarily used in females

Answer 25

false - primarily in males (is seen in females in practice, although evidence for use in females is limited and conflicting)

Question 26

how long of a trial of finasteride should be used to see a reduction in hair loss/hair growth

Answer 26

6-12 months

Question 27

how long of a trial of minoxidil should be used to see a reduction in hair loss or increase in hair growth

Answer 27

4-8 months

Question 28

true or false: if finasteride is stopped, hair loss will resume

Answer 28

true

Question 29

true or false: finasteride should NOT be handled by individuals who are pregnant or planning pregnancy

Answer 29

true

Question 30

what are some adverse effects to monitor for in patients taking finasteride

Answer 30

decreased libido, erectile dysfunction, reduced semen volume

rare: gynemocastia, mood changes, testicular pain

Question 31

this 5a-reductase inhibitor is more potent than finasteride, but does not have an indicate for treating androgenetic alopecia

Answer 31

dustasteride

Question 32

true or false: if a patient gets surgery for permanent improvement of their androgenetic alopecia, such as follicular unit transplantation or follicular unit extraction, tx with finasteride or minoxidil is often continued post surgery

Answer 32

true