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INTRODUCTION

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Features

  • Patch of complete hair loss and clean scalp

  • Exclamation-mark hairs

  • Small patches may recover spontaneously (~80%)

Treatment

  • Potent topical corticosteroids (e.g. betamethasone dipropionate 0.05% cream or lotion) bd—12 wks

  • Intradermal injections of triamcinolone (Kenacort A10) or

  • Minoxidil 5% 1 mL, applied bd to dry scalp (for 4 or more mths) only when hair growing

ANDROGENETIC ALOPECIA (MALE PATTERN BALDNESS)

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Treatment for men

  • Counsel re. accepting problem

  • Alternatives—wear toupee, wig or hair transplant

Medications

  • Minoxidil 5% 1 mL, applied bd to dry scalp (at least 6–12 mths) but expensive and hair loss resumes on cessation

  • Finasteride 1 mg (o)/d for min. 2 yrs. Same problem as above

Treatment for women

  • Counselling

  • Alternatives—hair styling, wigs, camouflage

Medications

  • Minoxidil (as for men)

  • Spironolactone or cyproterone acetate (specialist supervision)

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