Managing Hair Loss

    January 1998 in “ Current Therapeutics
    Robert Rosén
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    TLDR Different causes of hair loss require specific treatments, and most men and women will experience some form of hair thinning as they age.
    The document from 26 years ago stated that humans typically lose 100 hairs per day and by the age of 50, 1% of the population would have experienced a patch of alopecia areata. The treatment for alopecia areata usually started with a potent topical steroid or intradermal steroid injection. Tinea capitis was best treated with oral antifungals. No hair regrowth could be expected in areas of the scalp replaced by scar tissue. Drugs induced diffuse, not patchy, hair loss. Conditions like pregnancy, high fevers, sudden weight loss, operations, drugs, and severe emotional stress could produce telogen effluvium. All men and most women experienced androgenetic alopecia, which could be treated with topical minoxidil, systemic anti-androgens such as spironolactone and cyproterone acetate for women, and the selective 5-alpha-reductase inhibitor finasteride for men. Treatment had to be continued for at least 6 months. Diffuse scalp hair loss could occur in nutritional and metabolic deficiency states.
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