Hair loss
Posted by dkwinter

Labs

  • CBC
  • Ferritin
  • Iron studies
  • TSH
  • DHEA-sulfate
  • Testosterone

 

Etiologies

  • Alopocia areata (patchy or diffuse)
    •  Treatment: 
      • Dermovate lotion AAA twice daily
      • Triamcinolone acetonide (Kenalog) injection every 4-6 weeks
      • ​Betamethasone dipropionate cream 0.05% for at least 3 months
  • Androgenic alopecia (especially if family history of early hair loss in men or women)
    • Treatment:
      • Spironolactone (inhibits androgen receptor binding) start with 50 mg po daily
        • might be a good choice in women with hypertension or women with hirsutism
      • Topical minoxidil (Rogaine) foam (men or women)
      • Finasteride (men only)
  • Hereditary thinning
    • Treatment: topical minoxidil (Rogaine) solution (can partially re-enlarge the miniaturized hairs).
      • "5% topical minoxidil applied twice daily was recently proven more efficacious than the previously recommended 2% minoxidil; however, there is a higher incidence of side effects with the stronger preparation such as scalp pruritus, local irritation, and unwanted hypertrichosis (Callender et al., 2004). " --Medscape
  • Telogen effluvium due to stress or medications
    • ​Treat underlying disorder (such as anemia or hypothyroidism)