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Types of baldness (alopecia)
June 24, 2011
Baldness or, more correctly, an alopecia is a disease which is characterized by the pathological hair loss different degree of intensity leading to partial or their full loss.
There is this pathology for the most various reasons some of which are not clear, in view of small study. There is no uniform classification of an alopecia also. Now the alopecia shares on total (total absence of indumentum), diffusion (sharp baldness) and focal (baldness occurs on some, limited sites).
Also, the dermatology distinguishes a disease by origin and to clinical features:
Each of them, in turn, is subdivided into several types.
The alopecia is inborn. This type of an alopecia (alopecia congenita) is characterized by partial or total absence of hair bulbs that is caused by, allegedly, genetic anomalies and belongs to ektomezodermalny dysplasias. The alopecia inborn can be both an independent disease, and part of the general pathology. The disease is caused by disturbance of synthesis of certain amino acids and meets rather seldom.
The alopecia is seborrheal. Complication of seborrhea is the reason of a seborrheal alopecia it is connected with disturbance of work of sebaceous glands. Long qualitative and quantitative changes of the emitted skin fat lead to emergence of dandruff and seborrhea, and as a result to a hair loss. The seborrheal alopecia approximately occurs at 25% of teenagers during puberty and reaches peak by 23-27 years.
Symptoms of an alopecia of seborrheal type are painful feelings, emergence of dandruff, an itch of pilar part of the head. Hair become fat by sight and to the touch, stick together in careless locks. Head skin and roots of hair become covered by fat scales of yellowish or grayish color. The term of life of hair is gradually reduced, they I begin to drop out. There is a disturbance of process of physiological change of hair, new hair are gradually replaced with vellus. Indumentum begins to thin or the centers of bald spots appear.
Often to 30-year age, the hormonal background is normalized and work of sebaceous glands is recovered. Treatment of an alopecia of seborrheal type should be begun as soon as possible, with a campaign to the specialist trichologist or the dermatologist, diagnosis of a disease of hair in a trikhologichesky office is carried out. Self-treatment can lead to irreversible loss of hair.
Treatment of an alopecia in this case first of all is begun with fight against seborrhea. The complex of treatment consists of two stages. The fortifying stage assumes correction of a diet and its observance, improvement of a condition of an organism and immune system by reception of a vitamin course, observance of a day regimen and rest since the psychological state and immunity of the patient very much influence recovery speed. The alopecia seborrheal is treated by use of special ointments, shampoos, masks which contain complexes of the active elements stopping inflammatory processes and stimulating growth of hair.
Alopecia symptomatic (diffusion). The reasons of an alopecia symptomatic consist in complication of a course of a serious general illness: infections, an endocrinopathy and many others, and also as a result of poisonings, beam influence or long cytostatic therapy. Under toxic or autoimmune influence on hair nipples, their growth stops. The illness has total, duffuzny or focal character. After the termination of chemical influence, growth of hair is usually recovered.
Allocate separately groups of some diseases leading to a cicatricial alopecia:
- viral diseases, for example, shingles or chicken pox;
- bacterial diseases (syphilis, anthrax, furuncle, tuberculosis, etc.);
- fungal (favus, microsporia, infiltrative purulent trichophytosis);
- diseases of connecting fabric (system lupus erythematosus, scleroderma);
- hereditary disorders and defects of development, such as skin aplasia, epidermal nevus, hemiatrophy of the person, hematoma of hair bulbs, etc.;
- physical damages (mechanical injuries, thermal or beam influence);
- some types of new growths (planocellular cancer, syringoma, etc.);
- dermatosis of various genesis (lipoid necrobiosis, Brock's pseudopelade, sarcoidosis, Littla-Lassyuer's syndrome, etc.).
The cicatricial alopecia is treated only by a surgical method, way of a hair transplant. This operation is well mastered, a malotravmatichna and if the area of a hem small, gives fast effect.
The alopecia symptomatic in other types is most often curable and, the earlier the specialist will find out the reason of baldness and will start treatment, the positive forecast is higher.
Gnezdny alopecia. Most often the gnezdny alopecia strikes children and young people of both floors till 25 flyings. The disease etiology is up to the end not found out. In a pathogeny of a gnezdny alopecia, according to assumptions, the large role is played by head injuries, endocrine diseases or neurotrophical frustration with an autoimmune component. Hair drop out in the form of the centers of a round or oval form of various size, hair follicles are reduced in sizes. In clinical forms distinguish subspecies of a gnezdny alopecia:
- total – is observed total absence of hair on a scalp;
- subtotal – lack of hair on a scalp of more than 40%;
- local — one or several accurate roundish centers of an alopecia are defined;
- diffusion – is observed a noticeable poredeniye of hair on head skin;
- ofiazis — the centers of an alopecia strike all regional region of growth of hair on the head, a nape or frontotemporal area;
- universal – lack of hair on a scalp, eyelashes, eyebrows, Full or partial loss of vellus hair on a trunk.
The illness proceeds is unpredictable, the centers suddenly appear and also suddenly, in 3-6 months, can disappear. Sometimes the illness passes into a chronic form, the old centers grow, but new appear.
Statement of the diagnosis is carried out on the basis of a clinical picture and characteristic signs. Carrying out clinical and laboratory trials is recommended: the general and biochemical analysis of blood, microscopy of hair, definition in blood of level of cortisol, KSR, a X-ray analysis of a skull, REG, hormonal blood test.
The Gnezdny alopecia is recognized as a multicausal disease. Treatment of an alopecia of this type complicates difficulty of identification of the main reason of the mechanism of a course of a disease and therefore, there are problems in its efficiency.
The alopecia is premature. The mechanism of an androgenic alopecia is most studied. Development of a disease is connected with uncharacteristic effect of androgenic hormones that is caused by hereditary factors. The alopecia premature or androgenic, the most frequent type of baldness, is observed at men and, sometimes, at women. At men the onset of the illness is shown during puberty and finally forms by 30 years. In 60% of cases the developed clinical picture is observed in 40-50 years. Women get sick much later, almost in half of cases, the onset of the illness is necessary on 60-70 and is expressed not by full baldness, but a big or smaller poredeniye of hair.
Symptoms of an alopecia premature, are substitution of long hair on vellus. The hair loss in frontal and parietal area begins, then process covers other sites of the head. As a result, hair remain only at the edges of pilar part of the head.
Skin on hairless sites becomes thinner, becoming more smooth and brilliant. Openings of hair follicles become imperceptible. At early stages of a premature alopecia allocate with a histologic way a focal perivascular basphilic degeneration of a connective tissue vagina of a hair. During several cycles of change of hair, the struck follicles progressively decrease. Below the wrinkled follicle it is possible to see in the beginning the sclerosed remains of a connective tissue vagina which disappear over time.
It is not possible to achieve recovery of indumentum, most often, but intensive systematic fortifying treatment helps to slow down process of baldness significantly.
Treatment of an alopecia
The main condition in successful treatment of an alopecia of all types is elimination of an adverse psychological background, disturbances of functions of a digestive tract, kidneys and a liver, the nervous and endocrine systems, the centers of persistent infection, a helminthic invasion and other factors promoting development of a disease.
- psychotropic and nootropic drugs (Azaphenum, Nootropil, Sibazonum),
- immunokorrigatorny drugs (Dekaris, Methyluracil, Taktivin),
- vitamins (And, E, the polyvitamins containing microelements), Phytin, Biotin.
The Gnezdny alopecia, in addition to the listed drugs, demands purpose of vasoprotectives (Doxium) and the drugs improving microcirculation (trental). Sometimes, in hard cases, use of corticosteroid therapy in the form of an obkalyvaniye of the centers or inside is possible. Nevertheless, there is no guarantee from recurrence.
From physiotherapeutic methods at treatment of an alopecia use Darsonval's currents, and in hard cases it is reasonable to combine UV rays with reception of photosensitizers (ammifurin, beroksan) or to carry out photochemotherapy.
The reflexotherapy, in particular, a lazerorefleksoterapiya gives a positive effect.
From outside means use of the irritating spirit vtiraniye (tincture of red pepper, extract of naftalanovy oil), corticosteroid creams, drug is effective Regeyn whose part is minoksidit. Carry out course treatment of an alopecia by vtiraniye of a pilastin or a silokast to the defeat centers. The course consists of 6 days, an interval between courses of 1,5 months.
Strict observance of a diet is important. Obligatory inclusion in a diet of fresh vegetables (especially cabbage and carrots); fruit (apricots, dried apricots, apples). And also the laminaria and products containing gelatin in large numbers (jelly, jellied dishes, jelly). It is necessary to exclude completely from a diet alcohol, coffee, smoked products, a pickles, seasonings, marinades, extractive substances, and also, to limit reception of fats and carbohydrates.
Section: Trichology (Diseases of hair)