Alopetion (baldness) – the progressing hair loss leading to baldness of the head or other hairy sites of skin. Allocate an alopetion diffusion (thinning and a poredeniye of hair on all head), focal (emergence of the centers of total absence of hair), androgenic (on men's type, connected with level in blood of male sex hormones) and total (hair are absent completely). Both men, and women are subject to different types of an alopetion. Alopetion represents the expressed cosmetic defect and a serious psychological problem.
Alopetion is a full or focal hair loss in places of their usual growth. More often the alopetion is observed on a hairy part of the head. About a half of men after 50 years and the third part of women have various signs of an alopetion.
Reasons and clinical manifestations of alopetion
Loss of mature hair usually leads to decrease in density of indumentum and is rather rare to a total alopetion. The reasons of loss of mature hair quite a lot, for example, in view of physiological changes of an organism during pregnancy of the phenomenon of an alopetion can come after the delivery. Long reception of the retinoid, oral contraceptives and medicines which are slowing down fibrillation especially in combination with constant stressful situations and endocrine violations quite often become the alopetion reason. The lack of an organism of iron, zinc and other violations of food too adversely affects indumentum density.
As a rule, the alopetion begins gradually with the advent of small high temples in a parietal or frontal part of the head, skin gains glossy gloss, the phenomena of an atrophy of hair follicles are observed, in the center of the centers it is possible to meet the single long hair which are not changed by sight.
If loss of the growing hair is the reason of an alopetion, then over time it can lead to full loss of hair. Pathogenetic the alopetion of this kind is caused by mycoses, radiation therapy, poisonings with bismuth, arsenic, gold, thallium and boric acid. Antineoplastic therapy with use of tsitostatik can precede a hair loss and an alopetion.
The androgenic alopetion is observed generally at men, it begins to be shown after puberty and is formed by 30-35 years. Development of an alopetion in this case is connected with the increased amount of androgenic hormones that is caused by hereditary factors. Clinically androgenic alopetion is shown by replacement of long hair on pushkovy which are even more shortened over time and lose a pigment. In the beginning there are symmetric high temples in both temporal areas with gradual involvement in process of a parietal zone. Over time high temples merge because of peripheral growth.
The cicatricial alopetion at which the hair loss is followed by emergence of brilliant and smooth sites of a hairy part of the head differs in the fact that similar sites do not contain hair bulbs. Congenital anomaly and defects of hair follicles can be the reason of this kind of an alopetion. But much more often lead infectious diseases, such as syphilis, a leprosy and herpetic infections to a cicatricial alopetion. Changes of ovaries and a hypophysis as giperplaziya and polikistoz, bazalnokletochny cancer, long reception of steroid medicines also provoke an alopetion of cicatricial type. Influence of aggressive chemicals, burns, frostbites of head skin are the most frequent exogenous reasons of a cicatricial alopetion.
Gnezdny alopetion when sites of baldness are not followed by scarring and are located in the form of the roundish centers of the different size, appears suddenly. The reasons of a gnezdny alopetion are not known, but meanwhile, sites with the phenomena of an alopetion tend to peripheral growth that can lead to a total hair loss. More often the gnezdny alopetion is observed on a hairy part of the head, but process of baldness can strike area of a beard, moustaches, eyebrows and eyelashes. Originally the centers of an alopetion have the small sizes to 1 cm in the diameter, the condition of skin is not changed, but insignificant hyperaemia can sometimes be observed.
Mouths of hair follicles in a zone of defeat are well noticeable. In process of peripheral growth the centers of an alopetion gain scalloped character and merge among themselves. In a circle of sites there is a zone of the loosened hair which at insignificant influence easily are removed, hair in this zone for the root are deprived of a pigment and terminate in a club-shaped thickening in the form of a white point. They received the name "hair in the form of an exclamation mark". Lack of such hair demonstrates that the gnezdny alopetion passed into a stationary stage and about the end of progressing of a hair loss. In several weeks or months in the alopetion centers growth of hair is restored. At first they thin and colourless, but over time their color and structure gain normal character. The fact that growth of hair was resumed does not exclude probability of a recurrence.
The Seboreyny alopetion is observed approximately in 25% of cases of seborrhea. Baldness begins during puberty and reaches the maximum expressiveness by 23-25 years. In the beginning hair become fat and brilliant, externally look as oiled. Hair stick together in a lock, and on head skin there are densely sitting fat scales of yellowish color. Process is followed by an itch and quite often seboreyny eczema joins. Baldness begins gradually, at first the term of life of hair is shortened, they become thin, thin and gradually long hair are replaced with pushkovy. In process of development of a seboreyny alopetion process of a hair loss begins to accrue, and the bald head becomes noticeable, it begins with edges of a frontal zone towards a nape or with a parietal zone towards frontal and occipital. The center of baldness is always bordered with a narrow tape of the healthy and densely sitting hair.
Trikhotillomaniya, when at the person the uncontrollable inclination to wrest of own hair is observed and damage of hair bulbs at excessively hard zapletaniye of braids can lead to a traumatic alopetion which, accepting chronic character, quite often comes to an end with full baldness.
Diagnostics of alopetion
Diagnostics of alopetion is possible as at the patient either decrease in density of indumentum, or sites with total absence of hair is observed. It is much more difficult to establish the reason for an alopetion to appoint the scheme of treatment. Consultation of the trichologist is for this purpose necessary.
Usually conduct comprehensive examination of the patient which includes inspection of a hormonal background – a research of functions of a thyroid gland and determination of level of men's hormones in blood. Full blood test is also necessary for identification or an exception of violations of functions of immune system. It is necessary to exclude or confirm the syphilitic nature of an alopetion for what conduct serological examination of blood and the RPR test.
At patients with a gnezdny alopetion the number of T - and V-lymphocytes is usually reduced and positive test with a pandiculation of hair – a careful pandiculation for a core of a hair leads to its easy removal.
Microscopic inspection of a core of a hair and the centers of baldness on existence of fungi is obligatory, the biopsy of skin of a hairy part of the head allows to reveal or exclude dermatomikoza and cicatricial alopetion which developed against the background of a system red volchanka, a sarkoidoz or against the background of flat depriving. Carry in addition out the spectral analysis of hair.
Treatment of alopetion
In treatment the alopetsy mode of washing of the head can be any, except for a seboreyny alopetion when washing of the head has to be not more often than once a week. Use of nonaggressive detergents which part extracts of herbs are promote growth of hair.
Besides vitaminokompleks and the main treatment it is necessary to reconsider a diet. At baldness and at a hair loss food has to contain a large amount of zinc and copper. It is necessary to include a liver, seafood in a diet, grain and cereal, mushrooms, green vegetables, orange and lemon juice – these products have to be used at least once a day. The exception of coffee, alcohol and extractive substances contribute to normalization of the autonomic nervous system, but also these substances are contraindicated during administration of drugs, appointed at an alopetion.
If loss of mature hair is the main reason for loss of hair, then the maximum manifestations of an alopetion are observed in three months after influence. As a rule, after cancellation of medicines, normalization of the mode of life and food, pilosis is quickly restored. At an alopetion because of loss of the growing hair their maximum loss is observed in a week or in several days after influence of a provocative factor. At elimination of the main reason growth of hair is quickly restored.
The cicatricial alopetion demands elimination of the main reason not to allow total loss of hair then resort to surgical treatment with excision of sites of cicatricial fabric and hair transplant.
At an androgenic alopetion minoksidit the medicinal solutions containing or its analogs, promote growth of hair at a considerable part of patients. However it is necessary to consider that efficiency of a minoksidil depends on application duration. Usually growth of hair is observed in 10-12 months after the beginning of therapy. Medicine has contraindications and side effects, and therefore to patients with violations of work of cardiovascular system, it is contraindicated to pregnant women and the feeding women. An alternative way of treatment of an alopetion of androgenic character is reception of hormonal medicines for correction of a hormonal background and the subsequent transplantation of hair.
For treatment of an androgenic and seboreyny alopetion at women appoint anti-androgenic oral contraceptives which normalize a hormonal background and favorably influence a condition of skin, hair and nails. Try to pick up such oral contraceptives which have a minimum of contraindications and practically do not cause side effects.
The Gnezdny alopetion usually passes independently within two-three years, but even at self-healing a frequent recurrence is observed. As stresses and hypovitaminoses, vitamin therapy, medicines the normalizing works of a thyroid gland and sedatives are the main reason for this alopetion, have good effect. For stimulation of growth of hair in a trikhologiya use furokumarinovy medicines (medicinal substances on the basis of plants). It is necessary to consider that the scheme of treatment of an alopetion depends on individual sensitivity and on season, and therefore use of these medicines during therapy of an alopetion has to take place under control of the doctor.
Therapy of a traumatic alopetion has to be carried out together with psychologists and psychiatrists as treatment comes after the termination of wrest of hair. Use of sedative medicines and correction of behavior allow to eliminate in whole or in part maniacal behavior which led to a traumatic alopetion. If dermatomikoza are the reason of an alopetion, then carry out antifungal therapy with observance of all anti-epidemic actions in the center. After treatment growth of hair usually is resumed. However, for example, at a long current of a favus, the postfavusny alopetion is observed resistant and then the only method of restoration is transplantation of hair.
Forecast and current of alopetion
If is the reason of a hair loss , violations of a hormonal background and a trikhotillomaniye, then after correction there comes the complete recovery of indumentum. At a cicatricial and total nested alopetion hair usually are not restored as hair follicles have serious damages, then transplantation of hair is required.
In general, success of treatment of an alopetion depends on as far as all doctor's instructions and from at what stage of a disease the patient asked for medical care are observed. Folk remedies in combination with drug treatment can accelerate recovery. Independent therapy is usually not expedient and ineffective as it does not remove the main reasons for emergence of an alopetion.