Hair disorders Mohammed A. AlShahwan MD

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Presentation transcript:

Hair disorders Mohammed A. AlShahwan MD Assistant professor & Consultant Dermatologist

Objective Normal anatomy of hair follicle and hair cycle Causes, features and management of non scarring alopecia Causes and features of scarring alopecia Causes and features of Excessive hair growth

Hair Types Vellous Terminal

Hair Cycle

How many hairs in the body 5 millions hairs in the body 100,000 in the scalp Growth rate 0.3mm/day for scalp hair

Alopecia None Scaring (Reversible) Scaring (Irreversible)

Alopecia Areata

Sudden hair loss ( localized or generalized) Alopecia Areata affects up to 2% 75% Self recovery with 2-6 months 30% +ve Family history Autoimmune

Clinical findings Well demarcated non-scarring hairless patch Exclamation point Nail: pitting, ridges

Types of alopecia areata - Localized partial - Localized extensive - Alopecia ophiasis - Alopecia totalis - Alopecia universalis

Bad prognostic signs Young age Atopy Alopecia totalis, universalis, ophiasis Nail changes

Treatment 1. Observation 2. Intralesional Corticosteroids 3. Skin Sensitizers Anthraline Diphencyclopropenone (DPCP) others

Others Topical steroids &Minoxidil Systemic Steroids Cytotoxic Rx Phototherapy (PUVA)

Androgenetic Alopecia (Male and Female Pattern Hair Loss)

Androgen dependent loss of scalp hair Androgenetic Alopecia affects up to 50% of males and 40% of females Autosomal dominant with variable penetrance 85% : +ve family history

DihydorTestosterone (Active) Miniaturization of Terminal Hairs 5 ALPHA Reductase Testosterone DihydorTestosterone (Active) Miniaturization of Terminal Hairs

Male Pattern Hair Loss

Female Pattern Hair Loss

Treatment Topical: Minoxidil 2%- 5% solution Systemic: Finastride Spironolactone OCPs Hair transplant

Telogen effluvium Acute alopecia Reversible (but may be become chronic) 3-4 months

Treatment Remove or treat the cause Minoxidil 2%-5% Solution

Anagen effluvium Always related to cytotoxic chemotherapy Acute and severe alopecia Mostly reversible but not always

Scarring Alopecia SLE—DLE LP Sarcoidosis Leprosy Kerion Trauma

Excessive hair growth

Hirsutism Excess growth of androgen-dependent hair in a male pattern affecting Female Causes: Adrenal, pituitary, Ovarian (PCO), Turner syn., iatrogenic (drug), Idiopathic (the commonest)

Hypertrichosis Excess growth of hair in a non-androgenic pattern affecting both sex Causes: Congenital Acquired: drug, porphyria, endocrine (thyroid , anorexia nervosa )