Hair Loss Pre read SELFCARE

General causes of hair loss?

Hormonal changes, physiologic stress, chronic illness, medications, dietary changes, trauma, genetics

Two broad categories of alopecia?

Nonscarring alopecia and scarring alopecia

Forms of nonscarring alopecia?

Androgenetic alopecia, alopecia areata, anagen effluvium, telogen effluvium, cosmetic hair damage, trichotillomania, tinea capitis, secondary to meds/illness/diet

Examples of scarring alopecia?

Discoid lupus, syphilis, sarcoidosis, lichen planus, severe tinea capitis, chronic chemical/scalp damage

Most common form of hair loss?

Androgenetic alopecia (pattern hereditary hair loss)

Role of DHT in AGA?

DHT binds androgen receptors in follicles → miniaturization and shortened anagen phase → hair thinning

Why do women lose less hair in AGA than men?

Women have less 5α‑reductase, more aromatase → lower DHT, plus fewer follicular androgen receptors

Phases of hair growth cycle?

Anagen (2–8 yrs), Catagen (4–6 wks), Telogen (2–3 mos), Exogen (shedding)

Where can nonprescription products act in the cycle?

Prolong anagen phase and convert telogen hairs back to anagen (minoxidil acts here)

Presentation of MPHL?

Gradual recession of frontal hairline and vertex thinning → rim of occipital/temporal hair remains

Presentation of FPHL?

Gradual thinning over crown and mid‑frontal scalp without frontal hairline recession

Which hair loss types are self‑treatable?

Androgenetic alopecia (AGA) is self‑treatable

Which hair loss types need referral?

Alopecia areata, anagen/telogen effluvium, scarring alopecia, infection‑related, endocrine‑related, trichotillomania

Non‑pharmacologic treatments for hair loss?

Camouflage (wigs, weaves), topical fibers/powders, hair sprays/gels, surgical transplantation

Only FDA‑approved OTC for AGA?

Topical minoxidil (2% and 5% solution; 5% foam)

Gender differences in minoxidil approval?

Men: 2% & 5% solution and 5% foam; Women: 2% solution and 5% foam

Counseling points for minoxidil use?

Apply to dry scalp 2x daily; use recommended dose; expect initial shedding; continuous use needed for maintenance

Common local side effects of minoxidil?

Itching, irritation, dryness, scaling—less with foam formulation

Rare systemic side effects of topical minoxidil?

Headache, hypotension, tachycardia, facial swelling if ingested or overabsorbed

Minoxidil drug interactions to avoid?

topical corticosteroids, petrolatum, retinoids on scalp within 24 hrs

to prevent increased absorption

Exclusions to self‑treatment of hair loss?

Age <18

pregnancy/breastfeeding

recent endocrine dysfunction or dietary deficiency

scalp inflammation

scarring lesions

sudden severe loss

systemic illness signs