Alopecia (Synonym: Baldness.)
What do you understand by alopecia?
By alopecia is meant loss of hair, either partial or complete.
Name the several varieties of alopecia.
The so-called varieties are based mainly upon the etiology, and are named congenital alopecia, premature alopecia and senile alopecia.
Describe congenital alopecia.
Congenital alopecia is a rare condition, in which the hair-loss is usually noted to be patchy, or the general hair-growth may simply be scanty. In rare instances the hair has been entirely wanting; in such cases there is usually defective development of other structures, such as the teeth.
Describe premature alopecia.
Loss of hair occurring in early and middle adult life is not uncommon, and may consist of a simple thinning or of more or less complete baldness of the whole or greater part of the scalp. It usually develops slowly, some months or several years passing before the condition is well established. It is often idiopathic, and without apparent cause further than probably a hereditary predisposition. It may also be symptomatic, as, for example, the loss of hair, usually rapid (defluvium capillorum), following systemic diseases, such as the various fevers, and syphilis; or as a result of a long-continued seborrhœa or seborrhœic eczema (alopecia furfuracea).
Describe senile alopecia.
This is the baldness so frequently seen developing with advancing years, and may consist merely of a general thinning, or, more commonly, a general thinning with a more or less complete baldness of the temporal and anterior portion or of the vertex of the scalp.
What is the prognosis in the various varieties of alopecia?
In those cases in which there is a positive cause, as, for instance, in symptomatic alopecia, the prognosis is, as a rule, favorable, especially if no family predisposition exists. In the congenital and senile varieties the condition is usually irremediable. In idiopathic premature alopecia, the prognosis should be extremely guarded.
How would you treat alopecia?
By removing or modifying the predisposing factors by appropriate constitutional remedies, and by the external use of stimulating applications.
Name several remedies or combinations usually employed in the local treatment.
Sulphur ointment, full strength or weakened with lard or vaseline; a lotion of resorcin consisting of one or two drachms to four ounces of alcohol, to which is added ten to thirty minims of castor oil; and a lotion made up as follows:—
℞ Tinct. cantharidis, ............................. fʒiv
Tinct. capsici, ................................. f℥j
Ol. ricini, ..................................... fʒss-fʒj
Alcoholis, ................. q.s. ad. ........... f℥iv. M.
The following is sometimes beneficial:—
℞ Resorcin, ........................................ gr. lxxx
Quininæ (alkaloid), .............................. gr. xv
Ol. ricini, ...................................... ♏v-♏xx
Alcoholis, ...................................... f℥iv. M.
Another excellent formula is:
℞ Resorcin, ........................................ gr. lxxx-cxx
Ac. carbolici cryst., ............................ gr. xx
Spts. myrciæ, ................................... f℥iv. M.
And also the various other stimulating applications employed in alopecia areata (q. v.).
Other measures of value are: Faradic electricity applied daily for five minutes with a metallic brush or comb; daily massage, with the object of loosening the skin and giving more freedom to cutaneous and subcutaneous circulation; and the application, two or three times weekly, of static electricity by means of the static crown electrode.
(The application selected should be gently—not rubbing—applied daily or every second or third day, according to the case; if a lotion, moistening the parts with it; if an ointment, merely greasing the parts. Shampooing every one to three weeks, according to circumstances.)