Diffuse Hair Loss in Women in Clinical Practice
Authors:
R. Kučerová; M. Bienová
Authors place of work:
Klinika chorob kožních a pohlavních, Fakultní nemocnice a LF UP Olomouc
vedoucí odborný asistent MUDr. Martin Tichý, Ph. D.
Published in the journal:
Čes-slov Derm, 90, 2015, No. 5, p. 181-188
Category:
Reviews (Continuing Medical Education)
Summary
Diffuse hair loss is a common reason for the affected women to visit a dermatologist. The classification of diffuse effluvium type is based on the physiology of the hair follicle growth cycle. The most frequent type of diffuse hair loss is telogen effluvium that has many different causes (hormonal, drugs, trace elements deficit, etc.), which is sometimes difficult to determine as in the case of idiopathic chronic telogen effluvium. In the anagen or anagen-dystrophic effluvium, the causing noxious event (chemotherapy, radiotherapy) is, usually, evident. Autoimmune based alopecia incognita could cause diagnostic difficulties. A specific subtype of effluvium is an androgenic alopecia of females, also called “female pattern hair loss (FPHL)” which has typical clinical picture. The treatment of diffuse effluvium is aimed at eliminating the underlying cause, if known. In androgenetic alopecia is a frequent choice of drugs with anti-androgenic effect. Minoxidil in a 2% solution for external application is indicated in most types of diffuse effluvium for its ability to prolong the growth phase of the hair cycle. Finally, it is necessary to provide psychological support for patients in order to relieve the anxiety that stems from fear of losing their hair.
Key words:
hair follicle cycle – anagen – telogen – diffuse hair loss– telogen effluvium– dystrophic-anagen effluvium - female pattern hair loss – antiandrogens – minoxidil
Zdroje
1. BARTOŠOVÁ, L., JORDA, V., ŠŤÁVA, Z. Choroby vlasů a ovlasené kůže. 1. vyd. Praha: Avicenum 1982: s. 56.
2. BIENOVÁ, M., KUČEROVÁ, R. Dermatoskopická diagnostika alopecií. Čes-slov Derm, 2014, 89, 1, p. 3–7.
3. BREGY, A., TRÜEB, R. M. No association between serum ferritin levels >10 microg/l and hair loss activity in women. Dermatology, 2008, 217, 1, p. 1–6.
4. COTSARELIS, G., MILLAR, S. Towards a molecular understanding of hair loss and its treatment. Trends mol. Med., 2001, 7, p. 293–301.
5. CUSCAN, L., DUPONT, A., GOMEZ, J. L., TREMBLAY, R. R., LABRIE, F. Comparison of flutamide and spironolactone in the treatment of hirsutism: a randomized controlled trial. Fertil Steril, 1994, 61, p. 281–287.
6. FUTTERWEIT, W., DUNAIF, A., YEH, H. C., KINGSLEY, P. The prevalence of hyperandrogenism in 109 consecutive patients with diffuse alopecia. J. Am. Acad. Dermatol., 1998, 1, p. 831–836.
7. GUY, W. B., EDMUNDSON, W. F. Diffuse cyclic hair loss in women. Arch. Dermatol., 1960, 81, p. 205–227.
8. HEADINGTON, J. T. Telogen effluvium. New concepts and review. Arch. Dermatol., 1993, 129, p. 356–363.
9. JAWORSKY, C., KLIGMAN, A. M., MURPHY, G. F. Characterisation of inflammatory infiltrates in male pattern alopecia: implication for pathogenesis. Br. J. Dermatol., 1992, 127, p. 239–246.
10. KANTOR, J., KESSLER, L. J., BROOKS, D. G., COTSARELIS, G. Decreased serum ferritin is associated with alopecia in women. J. Invest. Dermatol., 2003, 121, p. 985–988.
11. KLIGMAN, A. M. Pathologic dynamics of human hair loss, I: telogen effluvium. Arch. Dermatol., 1961, 83, p. 175–198.
12. MAHÉ, Y. F., MICHELET, J. F., BILLONI, N., JARROUSSE, F., BUAN, B., COMMO, S., SEINT-LÉGER, D., BERNARD, B. A. Androgenetic alopecia and microinflammation. Int. J. Dermatol., 2000, 39, p. 576–584.
13. NORWOOD, O. T. Incidence of female androgenetic alopecia (female pattern alopecia). Dermatol. Surg., 2001, 27, p. 53–54.
14. NORWOOD, O. T. Male-pattern baldness. Classification and incidence. South Med. J., 1975, 68, p. 1359–1370.
15. O’DRISCOLL, J. B., MAMTORA, H., HIGGINSON, J., POLLOCK, A., KANE, J., ANDERSON, D. C. A prospective study of the prevalence of clear-cut endocrine disorders and polycystic ovaries in 350 patients presenting with hirsutism or androgenetic alopecia. Clin. Endocrinol., 1994, 41, p. 231–236.
16. PRICE, V. H., ROBERTS, J. L., HORDINSKY, M., OLSEN, E. A., SAVIN, R., BERGFED, W. ET AL. Lack of efficiency of finestride in post-menopausal women with androgenetic alopecia. J. Am. Acad. Dermatol., 2000, 43, p. 768–776.
17. REBORA, A., GUARRERA, M., BALDARI, M., VECCHIO, F. Distinguishing androgenetic alopecia from chronic telogen effluvium when associated in the same patient. Arch. Dermatol., 2005,141, p. 1243–1245.
18. REBORA, A., GUARRERA, M. KENOGEN A new phase of the hair cycle? Dermatology, 2002, 205, 2, p. 108–110.
19. RUSHTON, D. H. Nutritional factors and hair loss. Clin. Exp. Dermatol., 2002, 27, p. 396–404.
20. SAWAYA, M. E. Novel agents for treatment of alopecia. Semin. Cutan Med. Surg., 1998, 177, p. 276–283.
21. SHAPIRO, J., WISEMAN, M., LUI, H. Practical management of hair loss. Can. Fam. Physician, 2000, 46, p. 1469–1477.
22. SHUM, K. W., CULLEN, D. R., MESSENGER, A. G. Hair loss in women with hyperandrogenism: four cases responding to finastride. J. Am. Acad. Dermatol., 2002, 47, p. 733–739.
23. SINCLAIR, R. Chronic telogen effluvium: A study of 5 patients over 7 years. J. Am. Acad. Dermatol., 2005, 52, p. 512–516.
24. TOSTI, A., WHITING, D., IORIZZO, M., PAZZAGLIA, M., MISCIALI, C., VINCENZI, C., MICALI, G. The role of scalp dermoscopy in the diagnosis of alopecia areata incognita. J. Am. Acad. Dermatol., 2008, 59, p. 64–67.
25. TROST, L. B, BERGFELD, W. F., CALOGERAS, E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. J. Am. Acad. Dermatol., 2006, 54, p. 824–844.
26. TRÜEB, R. M. Chemotherapy-induced alopecia. Semin. Cutan. Med. Surg., 2009, 28, p. 11–14.
27. TRÜEB, R. M. Systematic approach to hair loss in women. JDDG, 2010, 8, 4, p. 284–297.
28. VAN NESTE, D., LEROY, T., CONIL, S. Exogen hair characterization in human scalp. Skin. Res. Technol., 2007, 13, 4, p. 436–443.
29. WHITING, D. A. Chronic telogen effluvium: increased scalp hair shedding in middle-aged women. J. Am. Acad. Dermatol., 1996, 35, p. 899–906.
Štítky
Dermatology & STDs Paediatric dermatology & STDsČlánok vyšiel v časopise
Czech-Slovak Dermatology
2015 Číslo 5
Najčítanejšie v tomto čísle
- Diffuse Hair Loss in Women in Clinical Practice
-
Současné praktické postupy pro vyšetřování a léčbu chronické urtikárie
Aktualizovaný přehled a interpretace doporučených postupů pro praxi - Itchy Rash in Pregnancy
- Mid-dermal Elastolysis: Case Report