Alopecia Male Pattern Baldness

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Alopecia occurs when the hair shaft is lost and the hair follicle cannot regenerate. This results in permanent hair loss. Alopecia is associated with a familial history and the aging process. Some patients experience alopecia earlier than others.

Some medications can cause temporary alopecia. These include anticancer (antineoplastic) agents, gold salts, sulfonamides, anticonvulsants, aminoglyco-sides, and nonsteroideal antiflammatory drugs (NSAIDs) such as indomethacin.

Table 20-2. Topical glucocorticoids.

Potency

Drug Name

Drug Form

High

Amcinonide 0.1% (Cyclocort)

Cream, ointment

Betamethasone dipropionate 0.05% (Dirposone)

Cream, ointment, lotion

Desoximetasone 0.25% (Topicort)

Cream, ointment

Desocimetasone 0.05%

Gel

Diflorasone diacetate 0.05% (Florone)

Cream, ointment

Halcinonide 0.1% (Halog)

Cream, ointment

Triamcinolone acetonide 0.5% (Aristcort A, Kenalog)

Cream, ointment

Moderate

Betamethasone benzoate 0.025% (Benisone)

Cream, ointment

Betamethasone valerate 0.1% (Valisone)

Cream, ointment, lotion

Desoximetasone 0.05% (Topicort LP)

Cream, gel

Flucinolone acetonide 0.025% (Fluonid)

Cream, ointment

Flurandrenolide 0.025% (Cordran, Cordran SP)

Cream, ointment, lotion

Halcinonide 0.025% (Halog)

Cream, ointment

Hydrocortisone valerate 0.2% (Westcort)

Cream, ointment

Mometasone furoate 0.1% (Elocon)

Cream, ointment, lotion

Triamcinolone acetonide (0.025%-0.1% (Aristocort A, Kenalog)

Cream, ointment, lotion

Low

Dexamethasone 0.1% (Decadron)

Cream

Desonide 0.05% (Tridesilon)

Cream

Fluocinolone acetonide 0.02% (Fluonid)

Solution

Hydrocortisone 0.25%, 0.5%, 1.0%, 2.5% (Cortef, Hytone)

Cream, ointment

Methylprednisolone acetate 0.25%, 1.0% (Medrol)

Ointment

Severe febrile illnesses, pregnancy, myxedema (condition resulting from hypothyroidism), and cancer therapies are conditions contributing to temporary hair loss.

A 2% minoxidil (Rogaine) solution has been approved by the FDA for treating alopecia. Minoxidil causes vasodilation. This increases cutaneous blood flow and stimulates hair-follicle growth. However, alopecia returns within 3 to 4 months after the patient stops using minoxidil. Systemic absorption of minoxidil is minimal and adverse reactions seldom occur.

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