This document provides information on androgenetic alopecia (male/female pattern baldness), including its definition, epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis. It begins with definitions and discusses that it is related to androgen hormones and genetics. It is more common in men than women and the risk increases after puberty and menopause. The pathogenesis involves testosterone conversion to DHT by 5-alpha reductase, which causes miniaturization of hair follicles over time through shortening of growth phases. Diagnosis is mainly clinical along with supportive tests. Treatment options presented include minoxidil, finasteride, anti-androgens, hair transplants, and
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This document provides information on androgenetic alopecia (male/female pattern baldness), including its definition, epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis. It begins with definitions and discusses that it is related to androgen hormones and genetics. It is more common in men than women and the risk increases after puberty and menopause. The pathogenesis involves testosterone conversion to DHT by 5-alpha reductase, which causes miniaturization of hair follicles over time through shortening of growth phases. Diagnosis is mainly clinical along with supportive tests. Treatment options presented include minoxidil, finasteride, anti-androgens, hair transplants, and
This document provides information on androgenetic alopecia (male/female pattern baldness), including its definition, epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis. It begins with definitions and discusses that it is related to androgen hormones and genetics. It is more common in men than women and the risk increases after puberty and menopause. The pathogenesis involves testosterone conversion to DHT by 5-alpha reductase, which causes miniaturization of hair follicles over time through shortening of growth phases. Diagnosis is mainly clinical along with supportive tests. Treatment options presented include minoxidil, finasteride, anti-androgens, hair transplants, and
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPTX, PDF, TXT or read online from Scribd
This document provides information on androgenetic alopecia (male/female pattern baldness), including its definition, epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis. It begins with definitions and discusses that it is related to androgen hormones and genetics. It is more common in men than women and the risk increases after puberty and menopause. The pathogenesis involves testosterone conversion to DHT by 5-alpha reductase, which causes miniaturization of hair follicles over time through shortening of growth phases. Diagnosis is mainly clinical along with supportive tests. Treatment options presented include minoxidil, finasteride, anti-androgens, hair transplants, and
Copyright:
Attribution Non-Commercial (BY-NC)
Available Formats
Download as PPTX, PDF, TXT or read online from Scribd
SUPERVISOR: dr. A. Sastri Zainuddin, Sp.KK Division of Dermatology and Veneorology Medical Faculty of Hasanuddin University Makassar 2011
DEFINITION Androgenetic alopecia is one form of hair loss which is related with androgen hormone and hereditary involved.
Also known as alopecia androtesticleas, male pattern baldness/female pattern baldness, common baldness.
EPIDEMIOLOGY MEN > WOMEN
MEN Can develop after the onset of puberty but mostly at age >30 years old
WOMEN >40 years old, 13% premenopause and increase after menopause
Incidence: White skin > Asia, Africa - Americans
Genetic factor androgenic hormone
ETIOLOGY Sistemic disease
Drugs
NORMAL HAIR GROWTH CYCLE
Anagen = growth
Catagen = involution
Telogen = rest
ANAGEN This is the name for the growing period of a hair follicle. The anagen or growth phase begins with resumption of mitotic activity in the hair bulb and dermal papilla, the anagen stage for the hair follicles in the scalp typically lasts about 2 to 6 years.
CATAGEN The resting phase. This transition period of a hair follicle from growth to rest is called the catagen stage. This stage of the hair growth cycle usually lasts about 2 to 3 weeks or so. During the catagen phase the deeper portions of the hair follicles start to collapse.
TELOGEN This is the resting period of a hair follicle. It is usually 3 to 4 months in length and at the end of this period older hairs that have finished their life will fall out and newer hairs will begin to grow. Up to 100 hairs in telogen phase are shed each day and about the same number of follicles enter anagen.
PATOGENESIS In androgenetic alopecia, testosteron converted to dihydrotestosterone (DHT) by 5 -reductase enzyme. High concentrate of DHT will affects the hair follicle that cause shortening of anagen phase and prolongation of telogen phase. Then the terminal follicle will converted to a vellus follicle causes thinning and shortening of the hair shaft. This process is known as miniaturization and it will result baldness of the scalp in progressively.
CONT... Testosterone
5 -reductase
Dihydrotestosterone (DHT)
Miniaturization of terminal hair
CLINICAL MANIFESTATION Baldness linked to the frontoparietal & vertex area (most in male) and crown (most in female) Male pattern baldness : Hamilton-Norwood classification
Female pattern baldnes : Ludwig classification
Hamilton-Norwood Classification
Ludwig Classification
DIAGNOSE There were 3 indications of early baldness: Gradual loss occurred in the area causing thinning widow's peak (Forehead, crown, and vertex) The hairs on the widow's peak area of thin, light, not black, and easy loss More severe thinning and widening over time
SUPPORTING EXAMINATION Laboratory analysis: Dehydroepiandrosterone (DHEA)-sulfate and Testosterone Biopsy: histopatology of androgenic alopecia Trichogram
The Histology of Hair Loss
TERMINAL HAIR
DIFFERENTIAL DIAGNOSE Trichotillomania manifest as a compulsive desire or habit to pull out the hair. The clinical presentation is usually quite distinctive, with a confluence of very short sparse hairs within an otherwise normal area of the scalp.
Alopecia areata is organ spesific autoimmune disease. Tipically presents with round patches of hair loss ada patches may be single or miltiple.
Cont... Tinea capitis is tipically presents with patchy hair loss assosiated with inflammation of the affected scalp.
Telogen effluvium is a reaction pattern to a variety of physical or mental stressor. If the inciting cause is removed, the shedding resolves spontaneously over the next several months hair in telogen phase return to normal.
THERAPY Goals: Increase coverage of the scalp Retard further hair thinning
Drugs: Topical minoxidil solution or foam: 5% for man and 2% for woman Oral Finasteride: 1mg daily Oral anti-androgen: spironolactone
Surgery: hair transplantation
Wearing wig
PROGNOSIS
COMPLICATION
Cosmetic disorders Anxiety Easy to exposure to sunlight (ultraviolet rays)
