Baldness in syphilis

Syphilitic baldness (alopecia syphilitica) in secondary syphilis is small-focal and diffuse, it is also possible persistent limited hair loss at the site of scars after healing of ulcerated deep pustular syphilides.

Small focal syphilitic alopecia (alopecia syphilitica areolaris) is the pathognomonic symptom of secondary syphilis.

It is characterized by a sudden, rapidly progressing appearance on the hairy part of the head of small, 1–1.5 cm in diameter foci of hair loss. Plains have an irregularly rounded shape, are arranged randomly, do not grow peripherally and do not merge with each other. Not all hairs fall out in the foci of radiation, as a result of which the skin of the scalp acquires a resemblance to "fur eaten by moths." In the areas of alopecia, redness, scarring and scarring of the skin are absent. The plesenia of the lobe is mainly located in the temporal parietal and occipital areas, less often they are observed in the area of ​​growth of the beard, mustache, pubis, sometimes on the eyebrows and eyelashes. In the case of a gradual loss and successive regrowth of hair on the eyelashes, the latter have an unequal magnitude (staggered eyelashes, the sign of Pincus).

Diffuse syphilitic alopecia (alopecia syphilitica diffusa) is characterized by acute generalized thinning of the hair in the absence of any skin changes. Hair loss usually begins with the temples and spreads over the entire scalp. The degree of manifestation of syphilitic alopecia is

various: from barely noticeable hair loss, slightly exceeding the size of the physiological shift, up to 100 hairs per day, to complete baldness. Sometimes hair falls out only on the hairy part of the head, in other cases alopecia in the area of ​​growth of beard and mustache, eyebrows, eyelashes and less often is added to this symptom - all hair, including gun hair, falls out.

In some patients, not only alopecia is noted, but the hair itself changes, which becomes thin, dry, dull, and sometimes abnormally rigid, resembling a wig.

Small focal and diffuse alopecia can be observed simultaneously in the same patient (alopecia syphilitica mixta).

Syphilitic baldness occurs, as a rule, during the first year of the disease, most often during the first fresh rash, but appears 2-3 weeks after the appearance of a skin rash, which corresponds to the usual period of hair loss after cessation of their growth. Syndrome alopecia can exist without specific treatment for 2–3 months, then hair growth is fully restored. Under the influence of anti-filic therapy, after 10–15 days, hair loss stops and after 6–8 weeks the baldness disappears.

The pathogenesis of syphilitic alopecia is not the same.

Small-focal baldness occurs due to the direct effect of pale treponema on the hair follicle and the development around it of inflammatory phenomena that interfere with the nutrition of the hair. This point of view is confirmed by the results of a histological study revealing specific infiltration around the follicles, consisting mainly of lymphocytes and plasma cells. In addition, marked dystrophic changes in the area of ​​the hair follicles are noted.

Diffuse alopecia occurs either as a result of syphilitic intoxication, or as a result of syphilis damage of the nervous and endocrine systems that regulate the function of hair follicles.

Differential diagnosis.Symptomatic diffuse alopecia may be due to various causes. Hair in these cases fall out quickly or gradually. Clinically, diffuse syphilitic alopecia, as a rule, does not differ from symptomatic hair loss of a different etiology, therefore, in all patients with a sudden diffuse alopecia of unknown etiology, it is recommended to investigate serological reactions to syphilis in the blood. Difuse alopecia in patients with acute infectious diseases (influenza, typhoid, scarlet fever, malaria, etc.) begins acutely, usually during the recovery period. With symptomatic diffuse hair loss, diseases of the endocrine glands (pituitary, thyroid, diabetes mellitus), pregnancy, oral contraceptive use, chronic liver diseases (hepatitis, cirrhosis), some malignant neoplasms (lymphogranulomatous) and others

Hair loss can be observed when ingesting anticoagulants, cardiac drugs, cytostatics, psychotropic drugs, drugs that reduce thyroid function, if poisoned by chemical substances, for example, thallium salts, etc.

Nest baldness (alopecia areata) is characterized by the sudden appearance of one or several small round-shaped areas of hair loss on the scalp. Due to the peripheral growth of individual bald spots or their merging with each other, large areas of alopecia with a diameter of up to 5–10 cm, with rounded or large festooned edges appear. The skin on bald areas may be slightly pink and puffy at first, but then it will have a normal appearance.

Its surface is smooth and shiny. Hair on the edges of the bald area in the period of its growth is easily pulled out. Then, the growth of foci of baldness stops and after several months, less often - the years, the hair is completely restored. In addition to the hairy part, nesting baldness can occur in the area of ​​beard growth, pubic hair, and eyebrows. Sometimes nesting alopecia turns into a total with the loss of not only all long hair, but also fluffy hair. Nesting and total alopecia are prone to recurrences.

Superficial trichophytosis and microsporia of the scalp are characterized by the formation of several small rounded foci due to thinning of the hair. The skin in the lesions has a pale pink color and is covered with grayish-white, scaly, scaly. Razhennye hair breaks off at a distance of 2-3 mm above the skin or on the exit from the follicle. Gradually, very slowly, hair thinning foci increase by peripheral growth and can merge with each other.

The disease begins, as a rule, in childhood and lasts for many years. In microsporia, the hairy part of the head is either affected in the same way as trichophytia, or all the hair in the lesions breaks off at a height of 4–6 mm above the skin level and appears as if shortly trimmed. Often the affected hair is shrouded in a white case of spores.

The scalp favus is characterized by inflammation of the skin, the appearance of dry, crust-like structures, bright yellow in color, with a sunken center. Razen hair loses shine, fades, turns gray and falls out without breaking off.

After the resolution of the inflammatory process and hair loss on the head, cicatricial atrophy of the skin and persistent alopecia form.

The diagnosis of trichophytosis, microsporia and favus should be confirmed by microscopic examination of the hair and skin scales and the discovery of elements of the fungus in them.

Early alopecia (alopecia praematura). The disease is observed only in men under the age of 20 years, most often suffering from seborrhea, complicated by dandruff. You hair fall begins with the parietal frontal areas and the crown. Hair becomes thin, then disappear.Persistent baldness occurs by 25-30 years.

Cicatricial alopecia (Broca's pseudopelade) is characterized by the appearance of areas of cicatricial alopecia on the saline part of the head, which are irregular in shape, sometimes coalescing. In the initial stage of the disease, moderately pronounced erythema perifollicularis and peeling can be observed, only atrophy of the skin without signs of inflammation is noted later. For a long time, however, isolated hairs may remain in the lesions.

Limited or common foci of cicatricial alopecia can occur as a result of injuries, burns, furunculosis, and deep forms of ringworm.

Discoid and disseminated lupus erythematosus on the skin and scalp is manifested by a triad of symptoms: erythema, hyperkeratosis and cicatricial atrophy. On the head, the lesions usually have a significant size and at first look like slightly infiltrated red spots with hyperkeratosis. After the resolution of the spots, cicatricial atrophy and persistent baldness remain. Isolated damage to the scalp is rare.

Lichen ruber planus (flat hair lichen, Picardy — Little — Lassuer syndrome). The detailed clinical picture of the disease is characterized by follicular papules on the skin and alopecia in various areas of the body, covered with long and gun hair. Diagnostic difficulties arise when patients have cicatricial alopecia only on the hairy part of the head. In these cases, attention should be paid to the presence of peripheral alopecia of follicular papules.

Types and forms

Doctors distinguish between three types of syphilitic alopecia:

• Diffuse begins with the temples and it is difficult to bind to the disease itself syphilis. There are practically no characteristic signs by which the diagnosis could be determined. Manifestation of the disease only after transferred syphilis or during the inactive phase.

• Small focal alopecia It starts from the occipital and temporal areas, pockets the size of one or two coins, irregularly shaped. Hair falls out incompletely, however, it can affect not only the head, but also other hairy areas - eyebrows, mustaches, and body hair.

• Mixed alopecia - This is a combination of the first two types. The beginning of baldness occurs spontaneously and rapidly. If the necessary treatment is started in time, the loss will stop and then the hair covering on bald areas will be restored.

Note! Of all the types of syphilitic alopecia, doctors consider the mixed type the most dangerous and difficult to treat.

Manifestation of syphilitic alopecia, starting from the temporal lobes of the head. Distribution gets pretty fast. It looks like ordinary baldness with severe toxic intoxication, but in fact everything is not so harmless. Such baldness arises unexpectedly, dramatically progresses.

If the main disease (syphilis infection) is treated, then in two weeks the hair stops falling out, after the elimination of the infection, hair growth is gradually restored and in 2-3 months naked areas are overgrown with new hair.

Also among the signs include: the rapid spread of bald patches all over the head, the difficulty of diagnosing syphilis during this period, the visible cessation of strands falling out 10 days after the infection of the body.

Treatment methods

In the treatment of syphilitic alopecia, the main task is to overcome the underlying disease, and then to achieve normalization of hair growth.

Doctors recommend a course of vitamin therapy, which will gradually restore the hair. The courses are long, with short breaks, if necessary with the change of the complex. Applying Pyrogenal in the treatment, the dose is gradually increased, bringing to 15 mg.

Corticosteroid ointments and drugs taken orally act effectively. Modern corticosteroid agents act on specific areas that are to be treated. The mechanism of their action is reduced to the neutralization of prostaglandins, which provoke inflammation in the body. However, there are contraindications to their use: tuberculosis, diabetes, potassium insufficiency, renal diseases, hypertension.

The doctor may prescribe the following drugs:

• Dermoveit. It includes strong hormonal components, acts quickly, is used to relieve the process, then alopecia is treated with easier means. The cost is about 420–540 p.

• Fluorocort. Glucocorticosteroids in the composition of the ointment does not allow to use this tool during pregnancy, breastfeeding, before 18 years. Acts on all types of alopecia, improves vascular permeability in the area of ​​baldness, helps to improve metabolism, nutrition of hair follicles. Price 260-350 p.

• Advantan. The active substance is prednisone. The drug relieves allergies, peeling, swelling, itching, eliminates inflammation. Moisturized dry skin. Price within 650–1300 p.

• Belogent. Ointment with gentamicin and betamethasone. Suppresses inflammatory processes, establishes a healthy metabolism in the affected areas of the skin. The cost of the drug is about 250-450 p.

• Beloderm. Corticosteroid drug with antiproliferative and antihistamine effect. It constricts blood vessels, relieves the discomforting symptoms of syphilitic alopecia, and other skin diseases. No side effects. Price 270-300 p.

• Hydrocortisone. Eliminates inflammatory processes at the site of application, there may be side effects if a virus is present in the body or a fungal infection develops. The cost of about 120 p.

• Lokoid ointment with hydrocortisone, quickly removes inflammation, relieves itching, allows hair bulbs to recover. Price about 350 p.

• Lorinden. Neutralizes the causative agents of bacterial and fungal infections. The cost of about 400 p.

Also, the positive dynamics is observed in the treatment of physiotherapy methods: darsonvalem, ultrasound, various currents.

Tip! Holders of long hair is best to have a short haircut. It helps to reduce the weight of the hair - they do not fall out so much, the blood flow to the roots increases, which helps with nutrition and oxygenation.

Rules of care during treatment:

• Shampooing daily or every other day to prevent the sebum from clogging up the pores.
• With combing hair, it is worth being careful, the skin of the head while affecting as little as possible. Never press the teeth too hard.
• Caring means to cancel, except those prescribed by a doctor, as excessive chemistry irritates the skin and provokes dandruff, spoils the hair structure.

Prevention

Timely diagnosis, follow-up care for serious infectious diseases, regular monitoring and control of syphilitic infection during the inactive phase, can prevent baldness.

Syphilitic alopecia is dangerous in cases where the main disease is not treated. With proper and systematic treatment, the chances of a complete cure are maximum. It is possible to restore the lost hair in six months, however, the strands will lose elasticity, become brittle and thin.

On average, a complete cure and getting rid of infiltration is possible in 3-5 months, and after a while the balding walls accompanying the disease disappear.

Useful videos

Alopecia - causes, characteristics and treatment.

What is alopecia? Its types and causes of occurrence.

Alopecia for syphilis

May have a focal and diffuse nature. Focal hair loss occurs as a result of cellular infiltration of hair follicles, which leads to a violation of their trophism.

The lack of nutrition provokes the dying off of germinative cells of the hair follicles and, as a result, hair fall out.

Diffuse hair thinning with syphilis

Due to the general intoxication of the body infection.

Such a phenomenon can be observed in any long-term infectious process, accompanied by massive poisoning of the body with microbial toxins.

Focal baldness is manifested by loss of hair on the head, mainly in the occipital and temporal areas. It is from these zones that the balding process begins.

The centers of alopecia have a rounded irregular shape, small size (up to 3-4 cm in diameter). Do not have a tendency to merge, any subjective symptoms (itching, pain, redness, peeling) pathology is not different. Due to the foci of the process, the scalp acquires a specific type of fur, broken by moths.

Diffuse alopecia is generalized. The centers of hair loss can be observed on the entire surface of the scalp and body.

In differential diagnosis, syphilitic alopecia is distinguished from the pathology of mycotic genesis (microsporia, trichophytosis). In this case, peeling will be observed in the areas of hair loss, and hair loss will be caused not by their hair loss, but by the section.

Pathology is also differentiated from other infectious diseases that can lead to massive hair loss. The simultaneous presence of both forms is possible - combined alopecia.

Hair loss manifests abruptly and continues intensively, taking a generalized character. Most often, this phenomenon is observed in male patients, rather than female. There is a pathology in every fourth or fifth infected with a syphilitic infection. In addition to progressive hair loss, at the height of the disease, a change in their structure occurs. They become dry, brittle, tough, and as a result they become similar to an artificial wig. Besides, with syphilis may occur cicatricial alopecia.

It develops on the skin after the resolution of a pustular syphilitic rash and is represented by persistent alopecia of the skin. This form of alopecia should also be clearly differentiated from the usual, caused by skin lesions of the pustular nature.

Alopecia can be attributed to syphilitic genesis only with the accompanying presence of other symptoms confirming a specific infection, as well as laboratory confirmed infection with pale treponemas.

Syphilis possibly baldness not only on the head, but also on the body. In this case, the hair may fall out under the arms, on the chest (for men), arms, legs.

Can pubic hair fall out of syphilis?

Yes, focal or diffuse alopecia can also affect the groin area, the anogenital zone, the perineum, the skin of the thighs.

If a hair fell outIn the hands, in the groin area and in other parts of the body, one can speak of a massive intoxication of the body with treponema and generalized alopecia caused by them.

Often, syphilitic alopecia also affects the face. Patients may fall eyelashes, eyebrows.

Eyebrow thinning symptoms are called tram syphilis. This name of this syndrome is explained by the fact that it can be identified extremely easily even visually, while in transport.

Eyelashes fall out in such a way that their length is different, because of what they look like steps. This phenomenon is called the Pincus symptom.

Male pattern baldness can also shift to a mustache, a beard.

Hair loss on beard and mustache occurs with the same manifestations as on the scalp.

Thus, hair loss in case of syphilitic infection may be limited only to the scalp. It can also occur with the involvement of facial hair in the pathological process - mustache, beard, eyelashes, eyebrows.

With more widespread lesion of the hair follicles, the alopecia process also involves different areas on the body.

It should be noted that the small-focal nature of baldness on the head is characteristic of syphilitic skin lesions. Pathology in this case is due to severe damage to the hair follicles due to the erosive ulcer process in the skin affected by pustules in secondary syphilis. In this case, one patient can experience two different forms of baldness at once - small focal and generalized diffuse.

The pathogenetic mechanism of different forms of alopecia of a syphilitic nature is different. With its focal form, the direct cause of the damage of the hair follicle is its defeat by treponema and the infectious-inflammatory process caused by it. As a result, the germinal (germ) cells of the bulb cease to receive nutrition. Dystrophic phenomena develop in them, as a result of which they gradually perish.

In the diffuse form, alopecia is caused by a violation of the neurohumoral regulation of metabolic processes in the tissues of the hair follicles caused by their massive intoxication with the metabolism products of treponema.

With the differentiation of syphilitic alopecia from other causes of pathology, hormonal disorders should be excluded. For example, endocrine disorders, pregnancy, taking contraceptive hormonal drugs. As well as oncopathology, severe liver failure (inflammatory, cirrhotic).

In the infectious genesis of pathology, however, due to other infections (malaria, typhoid fever) baldness manifests itself acutely during the period of clinical recovery.

Confirmation of the syphilitic nature of the syndrome is carried out by carrying out seroreactions. That is, treponemal and non-specific tests that detect antibodies to the causative agent of syphilis in serum.

When does syphilis hair fall out?

Hair loss does not begin immediately after the manifestation of the disease. And a few months after infection, about 3-4 months, sometimes six months.

This is due to the "deepening" of the pathological process, the accumulation of toxins in the tissues of the body, and general intoxication of the body. Which leads to focal and diffuse lesion of the hair follicles and, consequently, to hair loss.

Is it effective hair loss treatment for syphilis?

Yes, hair loss stops 10-14 days after the start of a course of etiotropic treatment of syphilis, in some cases later.

Does hair grow when syphilis falls out?

Yes, subject to the effectiveness of treatment after a few months (1.5-2), foci of baldness are again covered with hair.

Some sources, however, indicate that even in the absence of specific therapy, hair growth resumes some time after the manifestation of symptoms and their resolution.

If you suspect that you have syphilis, contact the author of this article, a venereologist in Moscow with 15 years of experience.

Alopecia - what it is, its types and causes

Alopecia is a pathological partial or complete loss of hair on the head, face, and / or other areas of the body, which occurs as a result of damage to the hair follicles. There are many of its classifications, some of which are based on forms of baldness, others - on the alleged causes and mechanism of development. Most of them are based on the one and the other, which does not facilitate the understanding of the disease and the choice of methods for its treatment.

But all the classifications combine the types of alopecia into two large groups:

Causes of disease

1. Hereditary factors and congenital diseases (ichthyosis, skin aplasia, pigment incontinence).
2. Discoid form of lupus erythematosus, which is an autoimmune chronic disease that manifests itself clearly limited to red round spots covered with scales of the epidermis.
3. Autoimmune and other systemic diseases - limited and systemic scleroderma, dermatomyositis, amyloidosis, scarring pemphigoid, sarcoidosis.
4. Lipoid necrobiosis - the destruction and death of cells and tissues due to the abnormally large deposition of fat in them. This condition is provoked by a metabolic disorder and is often associated with diabetes mellitus.
5. Lichen planus, fungal skin lesions (trichophytosis) and some infectious diseases.
6. Abscessing perifolliculitis, epilating and keloid folliculitis, characterized by inflammation in or around the follicles, often complicated by staphylococcal infection, as a result of which scars are formed.
7. Tumors of skin appendages, flat and basal cell skin cancer and some other diseases.
8. Mechanical, thermal injuries, chemical and radioactive damage, purulent inflammation.

The final cutaneous manifestation of these diseases is the formation of scars and the death of hair follicles in these areas.

Non-cicatrical alopecia

It makes up from 80 to 95% of all hair diseases. The etiopathogenesis of this group, in contrast to the previous one, remains poorly understood. Most likely, different types of diseases in this group are based on different mechanisms, although the causes and trigger factors in almost all types are the same in most cases. All types of non-cicatrized alopecia are united by the absence of a previous skin lesion.

Causes of non-cicatrical alopecia

1. Immune and autoimmune disorders, which in recent years play a leading role. They lead to the formation of immune complexes and autoaggression of the body in relation to the hair follicles. These disorders are found both independently and in combination with certain autoimmune diseases - chronic lymphocytic thyroiditis, vitiligo, hypoparathyroidism, adrenal insufficiency.
2. Genetic predisposition due to a gene predisposing to inadequate biochemical processes in the skin and increased sensitivity of follicle receptors to androgens.
3. Diseases and disorders of the function of the endocrine glands, various metabolic disorders, including amino acids, proteins and trace elements - selenium, zinc, copper, iron, sulfur.
4. Acute stressful conditions and a long-term negative psychoemotional effect, leading to a spasm of peripheral vessels and malnutrition of the follicles.
5. Vegetative, cerebral and other types of disorders of the sympathetic innervation of the scalp and face, leading to disorders of microcirculation of blood in the skin vessels. From this point of view, chronic neurotic and acute stress states, prolonged repeated negative psycho-emotional effects, chronic inflammatory processes in the nasopharynx, larynx and paranasal sinuses, chronically enlarged and painful submandibular lymph nodes, osteochondrosis of the cervical spine, neuritis of the occipital nerves are of great importance. All this is an irritant of the upper cervical nerve sympathetic ganglions that innervate the scalp.
6. Diseases of the digestive system, which lead to a deterioration in the absorption of nutrients and trace elements.
7. Exposure to certain drugs (cytostatics), acute and chronic industrial or household toxicity with chemicals (mercury, bismuth, borates, thallium), exposure to radioactive radiation.

Classification of non-cicatrized alopecia

The proposed classifications of non-scarring alopecia are fuzzy, they are based on signs of a mixed nature: both the main external clinical manifestations and causal factors. The most convenient classification is the division into alopecia:

1. Diffuse.
2. Focal or nesting or circular alopecia.
3. Androgenetic.

Diffuse alopecia

Diffuse alopecia can occur as a result of the physiological hormonal restructuring of the body during puberty, pregnancy and breastfeeding, during menopause. In the first two cases, excessive hair loss is not considered pathological and is transient after the stabilization of hormonal levels. Under the influence of various provoking factors, it can be more or less pronounced.

Diffuse alopecia is characterized by uniform, rapid throughout the head, hair loss of varying degrees. Loss of all hair is extremely rare. It is divided into:

• Anagen, which occurs during the period of active hair growth,
• telogen - hair loss in the resting phase of the follicles.

Most often, diffuse alopecia is triggered by a stressful state, taking narcotic drugs, certain drugs and contraceptives, a lack of microelements, especially if there is an iron deficiency in women with menstrual disorders, as well as people who have undergone gastric resection due to poor iron absorption due to lack vitamin “B12”.

Alopecia areata

Alopecia areata in women and men occurs with the same frequency. It accounts for about 5% of all patients with skin diseases. Single (at the beginning) symmetric foci of hair loss have a rounded or oval shape and appear more frequently in the occipital region. They tend to grow and merge, resulting in the formation of large areas of alopecia, the edges of which reflect cyclicality. The course of focal alopecia in most cases is benign and proceeds in three stages:

1. Progressive, during which the hair falls not only in the place of defeat, but also in the border zone with it. This stage lasts from 4 months to six months.
2. Stationary - the termination of the formation and merging of new foci of baldness.
3. Regressive - restoration of normal hair growth.

The varieties of focal alopecia include:

• marginal, in which foci occur along the edges of the scalp, often in the neck and temples, a variation of this form is alopecia in the form of a crown,
• naked, characteristic of the formation of large foci, exciting the entire head, with preservation of hair in small areas,
• shearer - hair breaks off in the lesion at a height of 1-1.5 cm, this variety is differentiated from fungal lesions (trichophytosis).

Regional form of focal alopecia

Focal alopecia stripping type

There is also an androgenic alopecia on the female and male type, associated with an imbalance of male and female sex hormones with their normal content in the blood. It is also possible to increase the content of androgens due to the presence of hormone-producing tumors, dysfunction of the hypothalamus, pituitary or adrenal cortex, a decrease in estrogen in diseases of the ovaries, thyroid, etc.

Depending on the area of ​​damage and the nature of the flow, these forms of focal alopecia are distinguished:

• benign, described above,
• malignant, which includes subtotal, total and universal forms.

Subtotal form is characterized by a slow progressive course. At the same time, the number of sites and their area not only gradually and slowly increase, but also combined with loss of eyelashes and hair in the outer areas of the eyebrows.

Total - within 3 months all hairs on the head and face fall out. If the hair and restored, then this process lasts for years and occurs in reverse order: eyelashes, eyebrows, face. Hair on your head grows last.

With a universal form, hair is lost not only on the face and head, but on the whole body and limbs.

Total form of alopecia

Androgenetic Alopecia

It accounts for 90% of all causes of alopecia in men and women.This type of baldness is distinguished by most authors in an independent, although the external manifestations are mainly diffuse and often combined with oily seborrhea. The disease is associated with an autosomal dominant-type genome inherited, the function of which is realized, presumably, through mechanisms that affect the action of enzymes in the hair follicles and papillae. These mechanisms lead to an increased transformation of testosterone into a more active form, and in women - into estrone. Therefore, the types of baldness in men and women may differ.

Another mechanism is the high affinity of receptors for testosterone and certain follicle enzymes. It is higher in balding areas than in non-infected areas.

Androgenetic Alopecia in Women

Androgenic Alopecia in Men

Alopecia Treatment

The principles of treatment are:

1. Elimination of contributing factors through the normalization of sleep, work and rest, the appointment of sedatives and antidepressants, in good nutrition and elimination of foci of chronic infection.
2. Prescribing zinc, vitamins with microelements, amino acid metabolites and noootropes (Cerebrolysin, Nootropil) by introducing them inside, as well as locally using mesotherapy, iono- and phonophoresis.
3. Improvement of the blood microcirculation and metabolic processes in the affected areas with the help of Curantil, Aminophylline, Trental, Doxium, Heparin ointment, Solcoseryl, etc. (annoying) means.
4. The use of immunomodulators (Inosiplex, Levamisole, Timopentin) and immunosuppressants (PUVA-therapy).
5. Topical administration of glucocorticoids to suppress autoimmune aggression. For malignant forms, they are used internally in the form of tablets or injections. Pulse therapy with Prednisone or Triamcinolone has proven to be effective in many cases of common forms of focal alopecia.
6. Using a biostimulator for hair growth (Minoxidil).

In cicatricial and in most cases of malignant forms of focal alopecia, the only method of treatment is surgical transplantation of viable follicles.

What is alopecia?

Alopecia Is a medically correct name. alopecia. Most often, this term means baldness for pathological reasons, but sometimes the phrase “physiological alopecia” can also be found. Under it understand the natural process of thinning and hair loss, which occurs in most people.

There are many different types of alopecia, each of which has its own development mechanisms and causes. The most common is the so-called androgenic or androgenetic alopecia, which is caused by genetic factors and hormonal changes in the body.

Hair loss currently considered one of the most common cosmetic problems. From a medical point of view, it belongs to the field of dermatology. There are many different methods of prevention and treatment, which, unfortunately, are not always effective.

In some cases, alopecia can be regarded not as an independent disease, but as a manifestation of another pathology or its consequence. For example, in some autoimmune processes or due to injuries, the skin in the scalp area may be damaged. Then baldness will be secondary. Sometimes this process is reversible, that is, the removal of the underlying cause of alopecia will cause the hair to grow back.

Alopecia can be local and capture the following areas:

• the scalp (most often under alopecia, this form is meant),
• beard in men
• eyebrows
• eyelashes,
• groin area,
• axillary region.

There may also be total alopecia, in which hair falls all over. Most often this is due to systemic processes in the body - disruptions in the immune system, genetic or hormonal disorders.

Sometimes local alopecia can be regarded as a symptom. For example, with ringworm or other fungal diseases of the skin, the hair splits and falls out at a specific site. However, in this case it is only a typical appearance of another disease, and its treatment will restore hair growth in the future.

What are the causes of alopecia?

There can be a lot of reasons leading to baldness. They can be divided into physiological and pathological. The physiological reasons include age-related skin changes. Part of the hair follicles will atrophy, the nutrition of the skin deteriorates, and the hair will gradually thin and fall out. This process takes a lot of time and proceeds gradually. An important factor is hereditary predisposition. It affects the rate of baldness, the age at which it starts, as well as the direct change in hairstyle (with which area baldness begins).

Among the pathological causes of hair loss are the following diseases:

• Hormonal disorders. Androgens have the greatest influence on the process of growth and hair loss. Hormone dihydrotestosterone damages hair follicles, which leads to their degradation and cessation of hair growth. Since the production of this hormone can be disturbed with a number of different diseases, there can be quite a few causes of alopecia. Alopecia sometimes accompanies such hormonal disorders as hypothyroidism or hyperthyroidism (for thyroid diseases), as well as disorders of the pituitary gland, which controls the work of other endocrine glands. Problems with the functioning of the pituitary gland, for example, are observed in Simmonds disease.

• The reaction to taking medication. Taking certain medications can also trigger hair loss. At the same time, hormonal mechanisms (via dihydrotestosterone), autoimmune or allergic processes can be involved. The most common medicines that can cause baldness are cytostatics, anticoagulants, ibuprofen, D-penicillamine, anti-malarial drugs. It does not necessarily mean an overdose or the wrong mode of medication. This side effect may occur (although rarely) when taking these drugs in therapeutic doses. It depends on the individual sensitivity of the organism. As a rule, rapid hair loss after a short course of treatment is almost not found. We are usually talking about pathologies in which patients take the above groups of drugs for several months or more.
• Stress. The cause of stress can be strong and long-term emotional distress, trauma, and sometimes just a change of familiar surroundings. It is believed that overall, stress is an adaptation mechanism. It is implemented through a series of hormones and biologically active substances that enter the blood. Prolonged release of these substances can be detrimental to the body. One of the effects can be baldness. In this case, it is most often reversible and treats well, if stress factors are eliminated.
• Hypovitaminosis.Vitamins are important components of various enzymes that are responsible for the conversion of some substances into others. Thus, the lack of vitamins slows down the metabolic processes. Each vitamin is involved in the nutrition of a particular tissue, so its lack has very specific symptoms. For normal hair growth, vitamins such as B2, B3, B6, H, E, as well as folic acid are of particular importance.Most of these vitamins are ingested with food, so it is important for patients with incipient baldness to keep an eye on their diet.
• Poisoning. Sometimes baldness becomes the result of ingestion of various toxins. In this case, we can talk both about the direct impact on the hair follicles, and about the indirect inhibition of hair growth (through the endocrine system, metabolism, etc.). Alopecia may accompany poisoning with substances such as thallium, mercury, chloroprene, some pesticides. Also, hair loss against the background of severe intoxication often accompanies chemotherapy in the treatment of cancer.
• Infectious diseases. Of infectious diseases, a common problem is fungal skin lesions, which cause a section of hair and local (focal) alopecia. As a rule, hair loss in these cases is temporary. A slightly different situation with bacterial skin lesions. In this case, often the formation of scars and the gradual overgrowth of hair follicles. Alopecia is irreversible. Infectious skin lesions in case of leishmaniasis, pyodermatitis, skin tuberculosis, syphilis, leprosy (leprosy), etc. can lead to such consequences.
• Congenital disorders. There are a number of congenital diseases or syndromes in which the intrauterine development of the skin and its appendages are disturbed. Then the hair follicles may be absent altogether or function poorly. In both cases, it will be about the absence of hair growth from birth.
• Chronic diseases. Hair loss can occur with long-term serious illnesses (infectious or non-infectious), which strongly affect the body's metabolism. Such pathologies are, for example, diabetes mellitus, chronic viral hepatitis, leukemia. Hair in these diseases first thin, and then completely fall out. This symptom is observed not only on the head. Eyebrows, fluffy hair on the skin, and hair in the armpits are also often thinning.
• Injuries. Baldness due to injury will also be discussed in more detail later. It appears due to the direct destruction of the hair follicles due to physical impact. This type of alopecia is called cicatricial.
• Autoimmune diseases. In autoimmune diseases, the formation of antibodies against the body's own cells takes place. In some cases, these antibodies attack the hair follicles, and the hair falls out, or their growth stops.
• Radiation sickness.Radiation sickness is a symptom complex that develops when radiation is applied to the body. If the dose received exceeds the threshold of 3 Gray, then there may be no general manifestations, but the follicles in the skin are already damaged and the hair falls out. At higher doses, symptoms of the hematopoietic system, gastrointestinal tract, nervous and urinary system are also observed. Radiotherapy in cancer is also accompanied by patient exposure. However, in this case, the radiation falls on a specific area. Therefore, hair loss can be observed only in the irradiation zone.

Causes of Alopecia in Men

In men, the most common cause of baldness (in more than 90% of cases) is androgenic alopecia. With this type of disease, it is not always a matter of a pathological process. It is just that a hair loss program at a certain age is implemented at the genetic level. The male hormone dihydrotestosterone is directly involved in this process. Unlike women, who have this hormone significantly less, men bald more often, and this process is more noticeable.

The degree and stage of physiological alopecia in men can be estimated on the Norwood scale. This scale reflects the localization of the area of ​​hair loss (as a rule, the line of hair on the forehead and hair loss at the crown), as well as the total area of ​​baldness.It should be noted that for physiological reasons baldness almost always affects only part of the hair. A certain amount, as a rule, remains on the back of the head or in the form of lines behind the ears. This is explained by the fact that hair on the back of the head has increased resistance (resistance) to the action of dihydrotestosterone. Completely bald people most often simply shave off the remnants of hair for aesthetic reasons. With hormonal disorders, infections and other pathologies, complete hair loss is also possible.

If we talk about pathological variants of alopecia (alopecia areata, skin infections, etc.), then they occur in men and women with approximately the same frequency.

Causes of Alopecia in Women

In women, the hormone dihydrotestosterone also plays a role in the development of alopecia. But hair loss happens differently. In particular, the so-called diffuse alopecia occurs. In most cases, it is the result of various pathologies or external influences.

Physiological hair loss for women is also characteristic, but it is manifested by the fact that hair grows more rarely, becomes thinner and brittle. The degree and stage of baldness in women is measured on the Ludwig scale. The principle of division in this scale is the expansion of the central parting in the scalp.

An important factor affecting the development of alopecia in women is pregnancy and menopause. In the first case, women often lose their hair immediately after childbirth. With menopause, the level of estrogen in the blood drops sharply. The balance between female and male sex hormones is disturbed, and at some point the action of dihydrotestosterone can lead to increased hair loss.

Causes of Alopecia in Children

Activation of hair growth occurs in the first days after the birth of the child. Alopecia, which appeared before the age of 3 years, most often is the result of various congenital disorders. In particular, we are talking about problems with the development of hair follicles in the skin, problems with the endocrine glands, various syndromes affecting the skin.

After 3 years, children most often have alopecia areata. On the head there is one or more foci of hair loss, which have a clear boundary. The appearance of this pathology involves quite a few different factors, but the final mechanism of its development has not yet been established. Unlike adults, in children, alopecia alopecia appears more often in the occipital region and can spread to the hair behind the ears. Sometimes the process of hair loss goes symmetrically. In most cases, there is a slow but persistent progression of the disease. Treatment is not always successful, but there are cases of spontaneous recovery. Alopecia areata can also occur in adolescents, but the prevalence of this disease in children is still lower than in adults.

Another common cause of focal baldness in children is ringworm. In medicine, to distinguish between microsporia and trichophytosis is two common variants of this disease, named according to the pathogen. Microsporia often affects the scalp, and when trichophytia, the nails and skin on other parts of the body can also be affected. Both diseases are caused by fungi and are infectious, that is, infectious. Hair loss occurs gradually, over several days or weeks. It begins 3 to 4 days after contact with a sick person or animal (cat, dog).

Beard alopecia

Beard hair loss is not such a common problem as alopecia of the scalp, but it can have similar developmental mechanisms and causes. In general, it is noted that the factors contributing to hair loss, sometimes locally affect the beard. Most often, the appearance of one or several small lesions in which hair growth stops.Because of their localization, such foci create a serious cosmetic defect in people growing a beard and mustache.

Normalization of diet, elimination of stress and proper skin care can gradually restore hair growth. No specific diseases that would affect this particular area have been identified. Often, patients with alopecia will sooner or later appear on the chin in areas of baldness and on the scalp.

Sometimes beard alopecia is associated with a number of dermatological problems with the skin of the face. In particular, we are talking about acne and pink acne (rosacea). Damage to the hair follicles is possible when the parasite Demodex follicuculorum is seeding the skin. Such cases are more common in men aged 18–30 years. Excess dihydrotestosterone affects the beard hair to a lesser extent, since their follicles, like hair follicles on the back of the head, are less sensitive to the action of this hormone.

Alopecia eyebrows

Eyebrow loss most often begins with the lateral (lateral) part. In most cases, it is one of the symptoms or manifestations of various systemic diseases. However, there are also a number of pathologies in which only eyebrows are affected, and alopecia does not extend to other parts of the body. Local loss of eyebrows may be, for example, the result of their improper plucking or damage to the hair follicles by the mite Demodex folliculorum. Then the process rarely spreads, but the eyebrows may fall completely.

From systemic diseases most often lead to the loss of eyebrows following pathology:

• Hypothyroidism. A decrease in the level of thyroid hormones usually develops with iodine deficiency, benign or malignant tumors of this organ, an autoimmune degeneration of the gland tissues.
• Secondary syphilis. Eyebrow loss is a possible, but not mandatory symptom. It occurs due to the spread of infection with blood from the primary focus.
• Diabetes. In this case, we are talking about metabolic disorders throughout the body, and the loss of eyebrows is most often combined with the appearance of alopecia in other parts of the body.
• Iron and vitamin B12 deficiency. It is a common cause of hair loss in pregnant women.
• Leprechaun (leprosy). Currently extremely rare in some tropical countries. The disease is characterized by an infectious skin lesion with characteristic changes in facial features.

Why does hair fall out after childbirth?

During pregnancy and lactation, the woman’s body undergoes serious changes. First of all it concerns the metabolism and hormonal levels. One of the possible consequences of these changes may be alopecia. Most often, it is a temporary problem, and as the body recovers, hair grows back.

In general, the causes of hair loss after pregnancy lie in the different effects of hormones on the hair follicles. If the male hormones (of which there are not so many in the female body) contribute to hair loss, then the female hormones, on the contrary, retain them. During pregnancy, the mother’s blood contains large amounts of estrogen. Because of this, even aged hair still does not fall out, and new ones continue to grow. After birth, the level of estrogen drops sharply. In proportion, an overweight of the hormone dihydrotestosterone occurs, and aged hair begins to fall out at an accelerated rate. Because of this, the physiological rate of hair loss increases by several weeks (and sometimes months). In this case, diffuse alopecia occurs with a uniform reduction of hair on the head.

Eyelashes and eyebrows (and sometimes hair) may begin to fall out in the later stages of pregnancy. But then the reason is rather a lack of certain nutrients. In particular, a pregnant mother needs a greater amount of vitamin B12 and iron.Without them, both diffuse and focal alopecia can occur, affecting various anatomical areas. All these violations are reversible, and with timely treatment to a doctor and qualified treatment, hair grows quickly again.

What are the types of alopecia?

There are several different signs by which alopecia can be classified. The correct classification is very important, as the treatment and prognosis in each case varies greatly. The simplest criterion is the area and localization of the pathological process. However, this criterion is not so important in the diagnosis.

The area and location of hair loss are the following types of alopecia:

• Diffuse alopecia. Under diffuse alopecia sometimes understand the type of pathological hair loss in women. In this classification, diffuse alopecia is not characterized by hair loss in a particular place, but by a strong, visible thinning of the hair over the entire surface of the head.

• Local (focal) alopecia. In this case we are talking about local hair loss in a small hearth. As a rule, it has a round or oval shape. There may be several such lesions on the surface of the head.
• Subtotal alopecia. Subtotal is called alopecia, in which hair falls not less than 40% of the surface of the head.
• Ophiasis. With this form, there is a gradual hair loss around the edge (circumference) or in a particular area (for example, only at the back of the head, only at the temples, etc.).
• Total alopecia. With total alopecia, there is a complete loss of all hair on the head (excluding the beard and mustache).
• Universal alopecia. In this case, we are talking about complete loss of hair, not only on the head, but also on the whole body (eyebrows, eyelashes, hair on the beard, body, in the armpits, in the pubic region) fall out.

This classification does not reflect the causes and pathological mechanisms that caused the disease, so the practical benefits of it are small. However, some forms have a very limited range of possible causes. For example, universal alopecia is most often seen in congenital diseases. An important disadvantage of this classification is that it is not constant. In other words, the same pathological process can begin as focal alopecia, then go into the subtotal, and then into the total form.

It is also customary to distinguish between two important types of alopecia, depending on what phase of growth are the hair that falls out. Classify the disease on this basis can only specialists after a careful study of the roots of the hair that has fallen.

Hair may fall out in the following phases:

• Anagen phase. This phase is the first in the process of hair growth. It is an active cell division, the production of structural components. Hair loss in the anagen phase occurs in practice quite rarely and always with various pathologies. Possible causes may be poisoning with certain chemicals, chemotherapy or radiotherapy. Hair starts to fall out only 3 - 4 days after the provoking effect. The process can capture the entire hairline and cause total alopecia.
• Catagenic phase. This phase is transitional. Hair loss at this stage of hair growth is rare, because the phase duration is only a few weeks (while the anagen phase lasts for years).
• Telogen phase. The telogen phase follows catagen. Hair loss in this phase occurs for most physiological or pathological reasons. The early onset of the telogen phase, for example, may be due to fasting, blood loss, prolonged fever. Also this type is characteristic of baldness after childbirth or after abrupt discontinuation of combined oral contraceptives (OCC).

However, this classification is not universal, since it does not cover the root causes and mechanisms of baldness. It is widely used as a step in the diagnosis. Ultimately, doctors need to determine the mechanism of the disease. Many different classifications have been proposed for this, none of which is universal. As a rule, the name of alopecia forms as independent diseases varies from one state to another.

From a practical point of view, it is most convenient to distinguish the following types of alopecia:

• androgenic alopecia,
• diffuse alopecia,
• cicatricial alopecia,
• alopecia areata,
• congenital alopecia,
• autoimmune alopecia,
• hormonal alopecia,
• seborrheic alopecia.

Androgenic Alopecia

In men, dihydrotestosterone is more than in women, so they often go bald before. However, in the female body, this hormone is also present in small quantities, so the hair gradually thin and fall out. A strong increase in the level of this hormone in women, leading to rapid baldness, is pathological.

The development of androgenic alopecia can be divided into the following stages:

• Initially, dihydrotestosterone joins the receptors of the hair follicles, but only modifies their work. Because of this, various problems begin with the hair - dry, brittle, dull.
• Further, problems with hair growth begin, as they begin to grow more slowly, and lost hair is restored worse. In general, the hair visually thin. However, metabolic processes still occur in the hair follicles, and with careful examination, hair is still found. However, it is short, thin and faded hairs that are indistinguishable at first glance.
• Then the hair follicles cease to produce their own hair, and baldness occurs when the hair falls out, but does not grow.
• On average, 10 to 15 years after the beginning of the process, the mouth of the follicle, which does not produce hair, grows with connective tissue. Hair growth after this becomes impossible, and drug stimulation of the follicles or blocking dihydrotestosterone will not return the natural growth of hair.

This process is most often observed on the scalp. If we talk about eyebrows, beard in men or other areas of the body, then the effect of dihydrotestosterone is usually felt weaker, but in general, the above process also takes place.

Alopecia in men on the background of androgenic alopecia can begin as early as 17–18 years old (after the formation of the genital system), and in women by 25–27 years old. We are talking about healthy people who simply have a genetic predisposition to early hair loss. In men, as a rule, alopecia begins from the forehead area (the forehead rises, so-called bitemporal bald patches appear) or from the crown (parietal area). In women, the hair at first falls along the central parting, from the frontal to the parietal region, but the front line of hair barely rises. Such features of the spread of alopecia are explained by the different sensitivity of the hair follicles to dihydrotestosterone. In the frontal and parietal region, they are more sensitive, and the hair falls out faster. In the occipital lobe, the follicles are almost not susceptible to this hormone, so there the hair can persist for a long time. As a rule, it is the back of the head that becomes a donor area during hair transplantation.

Cicatricial Alopecia

Cicatricial alopecia, according to most experts, is not an independent disease. With this form of baldness we are talking about the formation of scars (connective tissue) on the scalp. Because of this, hair follicles are destroyed, and hair growth stops. However, scars are only a consequence, the end result of other pathological processes.Thus, cicatricial alopecia can be considered a complication of other diseases.

Scars with subsequent local hair loss can be formed due to the following pathological processes:

• thermal burns
• mechanical injuries (scalped wounds),
• chemical burns (ingress of concentrated acids or alkalis),
• pyodermatitis (purulent infectious processes),
• ringworms (fungal diseases, including lichen),
• skin neoplasms
• local manifestations of some infectious and autoimmune diseases (tuberculosis, syphilis, sarcoidosis, discoid lupus erythematosus, scleroderma, etc.).

In these cases, the area affected depends on the initial pathology. As it progresses, the area may increase, and local alopecia will become total. This is especially true for infectious and autoimmune processes. The skin in these cases is almost always changed. There is a compaction, desquamation, or other pathological changes.

Alopecia Alopecia

Alopecia areata is recognized worldwide as an independent disease that has little to do with other types of alopecia. It is also called pelada, circular or focal alopecia (as an independent form, not having in mind only localization). The mechanisms for the development of this form of the disease are not fully understood. In the course of numerous studies, it was only possible to identify some factors that may influence the development of this pathology. According to statistics, people from 20 to 40 years old are most often suffering from alopecia areata, but it can also occur in adolescents. In persons older than 50 years, the disease is rare.

Currently, it is believed that the appearance and progression of alopecia areata are influenced by the following factors:

• genetic predisposition - within the family, in blood relatives, the frequency of the disease is much higher than the average for the population,
• immune disorders - Often patients find organ-specific antibodies or other manifestations of autoimmune processes (Hashimoto thyroiditis, vitiligo, transferred rheumatoid arthritis, etc.),
• infectious factor - the disease is more often observed in people with chronic infectious foci (caries, chronic tonsillitis, pharyngitis, otitis, etc.),
• psychosomatic factor - usually more pronounced in children and is in the pathological manifestations of prolonged stress or emotional stress (for example, increased intracranial pressure on this background),
• endocrine factor - just like with many other types of alopecia, the influence of thyroid hormones and male sex hormones is considered,
• circulatory disorders - with atherosclerosis or problems with blood circulation in the vessels of the head, the nutrition of the hair follicles of the arterial blood worsens (the risk also increases with some cardiac and respiratory diseases),
• nutrient imbalance - in the hair, dropped out from patients with this disease, the content of zinc is reduced and increased - copper.

The duration of the disease and its development is difficult to predict. In most patients, one or more lesions are formed. At first they thin, become thinner, and then fall out completely. The focus has clear boundaries, but the hair at the boundary of this focus is also thin, dull. They can be pulled out without serious consequences. In rare cases, other symptoms are observed in the hair loss zone. There is, for example, a decrease in skin sensitivity, a slight periodic itching, slight swelling, which usually goes away on its own in 1–2 days. Peeling of the skin, as a rule, is not observed. The patient may have other, new foci of hair loss, and not only on the head.

The disease may not respond to treatment for a long time, but, as a rule, the hair sooner or later grows back. At first, they are thin and dull, but gradually become normal.Hair growth can recover and spontaneously, without specific treatment. A relatively frequent consequence after hair regrowth is again hypopigmentation or depigmentation (the hair in this area is lighter). In rare cases, alopecia areata slowly progresses, the lesions grow and merge, leading to subtotal and then total alopecia. In about 10% of cases, patients experience associated nail problems (brittleness, dullness, fragility).

Congenital alopecia

Congenital alopecia (atriosis) exists as an independent genetic disease, and also occurs in combination with other congenital disorders. In this case, we are talking about the prenatal malformation of the skin in general, or about the absence of hair follicles as such. As a rule, with this disease, hair is absent all over the body.

This disease can occur in both men and women. Its frequency is quite low. The overwhelming majority of patients with alopecia are still not inborn, but acquired form. With atrichosis, effective treatment most often does not exist. There are no genes responsible for the formation of hair follicles in the prenatal period, or the follicles themselves are still there, but they are non-functional.

Congenital alopecia may be associated with the following problems:

• hypopigmentation or hyperpigmentation of the skin (too light or too dark color),
• peeling skin
• susceptibility to skin allergies,
• increased skin elasticity
• abnormal development of nails and teeth.

Types and symptoms of this disease

In our time, syphilitic baldness is divided into 3 types:

1. Small focal. In this case, baldness accounts for the region of the temples and occiput, creating on them small pockets of loss. The width of one such area is only 1-2 cm, while its shape is irregular. The foci themselves are scattered in different places that are not in contact with each other. It is important to note that the head of hair with small focal alopecia falls partially. In addition to hair loss, many patients notice the thinning of the mustache, beard and body hair.
2. Diffuse The beginning of this type of alopecia is the temporal region, after the defeat of which the prolapse passes to the main part of the head. This type of pathology has no characteristic signs that could be compared with syphilis. The disease clearly begins to manifest itself only after the transfer or lull of a dangerous infection.
3. Mixed This species combines both previous forms of alopecia, in which baldness begins quickly and suddenly. With proper treatment, hair growth resumes 2 months after the complete infiltration. This form of the disease is considered the most dangerous and difficult to cure.

The symptoms of the above types of syphilitic alopecia include:

• The rapid spread of baldness throughout the base of the head.
• Lack of syphilitic signs.
• Habitual to all loss with different foci of baldness.
• Difficult diagnosis due to syphilitic infection.
• Termination of loss after 10 days, after the spread of infection in the body.

With proper and timely treatment, hair is fully restored after 6-8 months, but strands can become more brittle and thin.

Therefore, it is important to consult a doctor in a timely manner in order to begin eliminating the causes of baldness and conduct a comprehensive treatment for hair loss.

During the diagnosis, a specialist will identify microsporia and other infectious pathologies of the scalp, as well as eliminate the scar degree of alopecia, which recurs without treatment. These measures are necessary in order not to aggravate the development of baldness, but to accurately identify the cause of hair loss.

When manifestations of relapse, doctors recommend cutting the hair as short as possible, thereby:

• Reduce pressure on hair follicles.
• Increase blood flow to the roots.
• Accelerate the movement of blood in the affected areas of the scalp.

Treatment of syphilitic baldness

In the treatment of this disease, the patient should take a course of vitamins that will heal the hair roots and normalize the growth of the strands. Currently, oral medications, creams and ointments are used to remove the infiltrate. Also, physiotherapy, ultrasound and other currents, which are prescribed by doctors with a large number of pathologies for hair loss, also provide a quick therapeutic effect.

During treatment, it is important to strictly follow the recommendations of the doctor, as well as some rules for hair care:

• To wash your hair is 1 time in two days to skin fat does not clog skin pores.
• Combing hair is recommended infrequently, while not tearing the skin, and not strongly pressing the teeth on the affected areas.
• It is not recommended to use hair care products, as they irritate the scalp and clog the hair structure with chemical components.

Common symptoms of secondary syphilis

The onset of secondary syphilis is considered to appear on the skin and mucous membranes of various specific rashes. The elements are diverse, but it is possible to identify patterns in the appearance of the rash and its general properties:

1. rash spreads everywhere, dissemination is characteristic of secondary syphilis,
2. benign course: the rash gradually disappears without destroying the skin and mucous membranes,
3. lack of fever,
4. rash appears on healthy skin and is clearly demarcated from it,
5. the elements are not accompanied by subjective feelings (itching, pain, paresthesias),
6. red shades of rash (cherry, copper red, bluish and others),
7. the difference in the shape and size of the rash,
8. high contagiousness of erosive and ulcerative elements, that is, the ability to infect other people,
9. self-disappearance of lesions rash,
10. positive serological reactions (Wasserman reaction).

The course of the disease is undulating, there are three periods of secondary syphilis: fresh (early), recurrent (relapse), latent period. In the absence of therapy, the rash disappears within 2-10 weeks, and after a while appears again. With the progression of the process, subsequent waves of eruptions have characteristic features:

1. the amount of rash with each new episode decreases,
2. an increase in the size of the elements at each recurrence,
3. elements of the rash are grouped with the formation of various shapes,
4. rash is localized mainly in places of friction and pressure.

The elements of secondary syphilis of the skin and mucous membranes are called secondary syphilides and are divided into groups: papular, spotty (roseolous) and pustular. In addition, in case of secondary syphilis, pigmentation disorders and hair loss are observed.

Roseola rash

Roseola are round-shaped vascular formations up to 1 cm in diameter and spread along the lateral surface of the body. The boundary of the spots is fuzzy, they are flat, they do not rise above the surface of the skin. The color of the elements varies from bright red in the first episode to pale pink in subsequent waves of rash. Spots become brighter with friction, taking vasodilators, disappear when pressed. If roseola exists for more than 3 weeks, hemosiderin is deposited in them, and they darken, become brownish, and cease to disappear when pressed.

In addition to the classic version of roseolous rash, there are the following rare varieties of it:

1. Elevated (exudative, elevating, urticarial) roseola is characteristic of the first episode of secondary syphilis. The spots rise above the surface of the skin and resemble an allergic rash at urticaria. But roseola unlike allergic elements are not accompanied by itching.
2. Peeling roseola differs from the classic presence of peeling foci on the surface.
3. Roselicular (punctate, granular) roseola is characterized by the appearance of small nodules of red color on the surface of the mouths of the hair follicles.
4. Drain roseola appears in the presence of heavy rashes during the first episode of secondary syphilis. Elements of the rash combine to form large erythematous spots.

Papular rash

Papular rash with marginal peeling ("Bietta's collar")

Papules with secondary syphilis are characterized by a dense consistency, slightly rising above the skin surface. The size varies from small, miliary papules (1-2 mm) to coin-shaped (1-3 cm in diameter) and plaque (more than 3 cm) elements. Different papular rash and color: from pink-red to bluish. At the beginning, the surface of the rash is smooth, as it develops in the focus, scaling appears. Hyperkeratosis in the center of the rash element gradually disappears, and desquamation is localized only on the periphery of the plaque. Thus, the characteristic for secondary syphilis is formed - the “Bietta collar”. When papules spread in the marginal zone of hair growth on the head, another known symptom of secondary syphilis is formed - the “Venus crown”. Papular rash spreads to any part of the body, with the first wave of secondary syphilis, the foci do not merge and do not group.
There are also atypical forms of papular rash:

1. Seborrheic papules are characterized by the appearance of yellowish crusts on the surface of the lesions, while the elements themselves are localized on the “seborrheic” areas of the skin: on the cheeks, in the frontal area, on the nose and chin. Rash prone to fusion and the formation of large affected areas.
2. Psoriasis papules are similar to psoriatic plaques due to large whitish scales. Foci do not merge and are not prone to peripheral growth.
3. Cockard papular syphilide is characterized by the appearance of a large papule, around which small children appear.
4. Blistering syphilis is formed when small papules are randomly scattered around a large hearth.
5. Macerated (erosive) papules are usually localized in large skin folds, in the perianal area and between the fingers. These foci often merge, forming large defects with scalloped edges.
6. Broad (vegetative) warts are formed on the site of erosive papules. These are lesions with a rough surface, prone to peripheral growth.
7. Palmar and plantar syphilide is characterized by the localization of papules groups on the palms and feet.

Often, secondary syphilis is manifested by a mixed roseolous-papular rash.

Pustular rash

Impetiginous pustular syphilide

This type of rash today occurs only with significant violations of the body’s immune defenses (with HIV infection) and accompanies severe syphilis. Elements of the rash may exist unchanged for more than 3 months.

There are several types of pustular rash in secondary syphilis:

1. Immune syphilis is formed on the scalp, facial and pubic areas. On the surface of dark red or copper-colored papules, pustules appear on the surface with a thin tire for 3-4 days, along the periphery of which there is an infiltration band. Pustules open, in their place are purulent erosion.
2. Ospenoid syphilide is hemispherical elements up to 1 cm in size with an umbilicate impression in the center and a rim of hyperemia. As syphilide ages, a purulent crust forms on its surface, which lasts for 1.5 months.
3. Syphilitic ecthyma - the formation of infiltration occurs against the background of symptoms of general intoxication and fever, which is not typical for classical secondary syphilis. In the center of the infiltrate, a center of tissue breakdown is formed, with bloody clots transforming into brown crusts. Ecthyma is prone to peripheral growth and spread deep into the skin, as it heals, it is replaced by scar tissue.
4. Syphilitic rupee is a severely flowing form of syphilitic ecthyma. The lesion tends to grow rapidly and spread to the deeper layers of the skin. After resolving the process, pigmented scars remain.

Pigmentation disorders

Syphilitic leukoderma called foci of lack of pigmentation on the skin. The spots are located on the back of the neck, forming a "necklace of Venus."

The disappearance of the pigment is temporary, foci can remain on the skin for about six months. The reason for the reduction in skin pigmentation is the possible effect of treponema on the neural plexus of the neck, the elements of which are responsible for regulating the formation of melanin.

Mucous membrane lesions

Rash on mucous membranes in secondary syphilis are important for the diagnosis of the disease. In addition, the elements of the rash, localized on the oral mucosa, contribute to the rapid transmission of the pathogen from one person to another when kissing, using common cutlery by means of hygiene.

Treponema attack the tonsils (syphilitic tonsillitis), the larynx, the surface of the tongue and the inner surface of the cheeks. At the same time, there may be hoarseness, swelling of the tonsils without pain when swallowing.

The defeat of the internal organs

Hematogenous dissemination of treponema leads to inflammatory reactions in all internal organs: to gastritis, hepatitis, nephritis, unexpressed meningeal meninges, and other diseases. In secondary syphilis, these reactions are rarely accompanied by clinical symptoms, and organ damage is detected only during anatomopathological examination.

Information about the causative agent of syphilis

Syphilis - A disease perceived by many patients as a relic of the past.

However, the statistics of medical observations states that the disease is widespread in the modern human population. It is quite difficult to insure against it.

The disease develops if a pale treponema, a microorganism having a spiral shape, enters the body.

The disease refers to sexually transmitted diseases. But it can affect not only the genitals, but also any other parts of the human body. Because of this feature, pathology is called systemic.

With the wrong treatment or its complete absence, syphilis is prone to chronicity. Able to affect the nervous system irreversibly, without the ability to recover and with a high risk of death.

Syphilis is a complex disease that occurs in several periods.

The primary period of the disease is rarely diagnosed. Since it is characterized by a low symptom course, an almost complete absence of complaints.

For the first time the patient gets an appointment with a doctor in the secondary or tertiary period. At this time, the first symptoms of baldness appear on the body in case of syphilis.

Pale treponema is transmitted from person to person mainly through unprotected sex. The pathogen is not able to survive in the environment.

It is possible to infect with a household contact only in exceptional cases, with gross disregard for the rules of hygiene.

The incubation period of the disease lasts an average of 3-4 weeks. If the immunity of the infected person is strong enough, the incubation can be extended up to 100-120 days. Such a variation in the timing of incubation greatly complicates the diagnosis.

Alopecia for syphilis

Damage to the scalp is a deviation that develops if the infectious process has already gone quite far. The infection was chronized and not treated with classic antibacterial drugs for getting rid of the disease.

On average, the first signs of alopecia appear 6 months after infection has occurred. The term may increase in patients with strong immunity and decrease in the event that the immunity is weakened.

Hair loss can be both focal and diffuse.Focal changes are more common, as noted by doctors. They develop by a fairly simple mechanism.

The pathogen in the body provokes infiltrative changes in the skin of the head. As a result, hair follicles are deprived of the opportunity to fully feed, to transfer nutrients to the hair. The result is predictable: in the hair follicles, cells begin to die off. Hair falls out as a result, but a new one cannot grow during this period, since the follicle is deprived of trophism.

Diffuse alopecia develops if the body suffers for a long time from toxins, which the pale treponema secretes into the bloodstream. First of all, the patient notices that the hair in the nape and temples area is thinning. It is from these zones that the process of hair loss begins with a diffuse form of alopecia due to infection of pale treponema.

The doctor, conducting the examination, may notice small rounded lesions that have an irregular shape. The average diameter ranges from a few millimeters to 4-5 cm. The centers do not merge with each other, they are delimited by obvious strips of healthy hair.

Also, the patient does not complain of pain in the scalp, it does not bother with itching and other unpleasant symptoms. Peeling is also absent, signs of dandruff do not depend on the presence of the pathogen in the body.

The hair on the head of a patient suffering from syphilis, in appearance resembles fur, well eaten by moths.

This symptom is difficult to confuse with anything. It is important to distinguish syphilis from hair loss caused by fungal infections.

In the second case, itchy scalp may be present, often patients complain of peeling.

An experienced trichologist will be able to determine that when the fungus does not fall out of the hair, but split, which causes their thinning. Hair loss usually begins abruptly, without any prerequisites.

The representatives of the stronger sex symptom appears more often than women. On average, one in four men with syphilis suffers from hair loss.

Cicatricial alopecia with syphilis can also develop. A severely neglected pathology leads to marked changes in the structure of the hair. There is an increase in their fragility, stiffness, excessive dryness not only of the tips, but also of the hair as a whole.

Syphilis: hair loss elsewhere

Often a question from patients at the doctor’s office is whether pubic hair can fall out because of syphilis. Yes, doctors say that this is possible.

The fact is that diffuse alopecia affects the integument not only in the head area, but throughout the body. In addition, eyebrows, armpits, and in some cases legs are affected.

If not only the scalp is involved in the pathological process, the doctor has reason to say that the disease is severely neglected. Such alopecia is called generalized.

The loss of eyebrows is a symptom of pale treponema infection, known as tram type syphilis. The name is explained very simply. The fact that the thinning of the eyebrows is usually clearly visible, it can be seen even in public transport.

True, today, due to the active plucking of eyebrows, the habits of using tattooed tram syphilis are less common.

Separately, doctors isolate the symptom of Pincus. In this case, alopecia affects the patient's eyelashes. They begin to look like a staircase.

Some of the eyelashes are clearly longer, and some, by contrast, are much shorter. Hair loss on the beard and mustache in syphilis in the stronger sex is not uncommon. The symptoms in this case are not much different from the classical alopecia of the head. Deliver a large amount of inconvenience, as they reduce the aesthetic appeal of a person.

Doctors note that the syphilitic lesion of the skin is characterized by a small focal character in the second period of the disease.In this case, papules and pustules form on the patient's skin. It injures the hair follicles, does not allow the hair to grow fully, grow and eat. Naturally, deprived of the power of the bulbs are dying, new hair also does not grow.

When hair loss begins in syphilis

When syphilis hair falls out - a frequent question that can be heard from patients at the doctor’s appointment.

Doctors note that the first signs of hair loss appear after the disease manifests itself with its other symptoms.

Initially, the patient may not notice deviations. Since in principle, the body loses a small amount of hair threads daily.

However, the progression of pathology will lead to an increase in the number of dropped structures. In this case, the hair will grow more slowly than fall out, which will lead to the appearance of pockets of baldness.

On average, it takes 4 to 6 full months from the moment of infection of pale treponema to the development of alopecia. Naturally, the process can be accelerated if the patient's body is not able to fully protect themselves from infection. The process slows down if the patient's body is actively fighting the pathogen.

The duration of the formation of alopecia is due to the fact that the pathogenic microorganism needs time. A sufficient amount of toxins should be allocated to form a clinical picture of the disease. Also, treponema must be multiplied in sufficient quantities to form other symptoms of the pathology.

Does hair grow if you have syphilis?

Is there a chance for re-growth - another question that a doctor can hear from a patient suffering from symptoms of syphilis.

Doctors note that if a person started treatment of the underlying disease in a timely manner, he will be able to return to normal his hair over time. On average, recovery takes from one and a half to two months. In some cases, the recovery period may take a longer period of time.

In some sources there is information that hair growth can resume at the moment when syphilis moves from the primary to the tertiary period. However, in this case, the recovery will be temporary, incomplete.

Doctors note that the treatment of alopecia without treatment of pale treponema is ineffective. It makes no sense to treat a symptom without getting rid of the cause of its occurrence.

Doctors can tell the patient that the loss of cover will stop in 1-2 weeks. After the specific treatment of the disease with antibacterial drugs begins. Medicines in each case are selected individually.

Diagnosis of syphilis

Syphilis is a disease that is not diagnosed when signs of alopecia appear. After all, loss of sex can be caused by other diseases. An example is fungal diseases of the scalp.

Additionally required differential diagnosis with hormonal disorders.

The fair sex can lose hair during pregnancy. This does not at all indicate the development of syphilis, but does not exclude it, which is important to remember.

Another reason for baldness is the use of improperly selected contraceptive-type drugs, the self-prescription of such drugs. Cancer pathologies, liver diseases are also capable of starting the balding process.

Patients with suspected syphilis must be tested to confirm the presence of the pathogen in the body. The main material for the study is blood, which is examined using PCR, ELISA and other techniques. Only if the presence of pale treponema is confirmed in the body, the doctor can prescribe a specific treatment. If treponema is absent, other possible causes of the development of the disease are excluded.

Doctors emphasize the fact that in some cases it is required to exclude genetic susceptibility to baldness.

Which doctor will help in the fight against syphilis

Syphilis is a complex disease. It is not surprising that patients do not always know who to ask for help. Everything is very simple.

First of all, when suspicious symptoms appear, including alopecia, you should visit a dermatovenerologist. It is important to remember that going to a dermatovenereologist with just baldness in the absence of other symptoms of syphilis is irrational.

A dermatovenereologist will be able to assess the genital area and take into account the associated symptoms. Assign studies aimed at identifying in the body pale treponema.

If there is a syphilologist in the hospital, you can contact him. Syphilidologists specialize exclusively in the treatment, diagnosis and prevention of syphilis. But such a narrowly focused specialist is not in all hospitals.

A dermatovenerologist or a syphilidologist, at its discretion, may involve doctors of other specialties. For example, consultation of a general infectious disease specialist, a mycologist specializing in fungal diseases, may require. If necessary, the trichologist dealing with the problems of hair loss is involved in the selection of therapy.

Recommendations for the treatment of baldness in syphilis

Methods of treating baldness against syphilis are based primarily on ridding the human body of treponema pallidum.

It is almost impossible to stop the process of alopecia until the pathogen is destroyed.

To cope with the disease, doctors use antibacterial drugs that are susceptible to infection. The basis of modern treatment is various penicillin preparations. Since treponema shows the greatest sensitivity to them.

The preference of the doctor is given to benzylpenicillins, as not only effective, but also possessing the minimum quantity of side effects. The dose of the drug and the frequency of its introduction is selected for each patient individually.

Be sure to follow up after treatment with tests to ensure that the disease is completely defeated. If treponema pallus persists in the body, therapy is considered ineffective, a new treatment regimen is selected.

In addition to antibacterial agents, immunostimulants are prescribed to the patient, accelerating the healing process. Also prebiotics that protect the digestive tract from the negative effects of antibiotics.

The doctor may recommend physiotherapy, vitamin complexes.

Autoimmune Alopecia

This type of alopecia is quite rare. The cause of hair loss are failures in the immune system of the body. Certain proteins in the hair follicles begin to be perceived by the body as foreign bodies. Antibodies are produced against them, which sightingly attack and destroy the follicles. As a result, hair growth is disturbed and alopecia occurs.

Often, such violations occur after past illnesses, accompanied by hormonal disruptions. Sometimes this type of alopecia develops after childbirth. Alopecia is usually diffuse, since the structure of the hair follicles is the same, and antigens with blood flow and through diffusion in the tissues can get into any part of the body.

Sometimes alopecia occurs as a result of certain autoimmune diseases - systemic lupus erythematosus, scleroderma, skin sarcoidosis, etc. However, in these cases, antibodies are not produced against the follicles, but against certain cells in the skin, due to which scars are formed and the hair stops growing. Such alopecia is correctly called cicatricial, not autoimmune.

Hormonal alopecia

Alopecia can be conditionally attributed to hormonal alopecia with the following diseases:

• Basedow's disease (thyrotoxic goiter)
• Simmonds disease,
• Hashimoto autoimmune thyroiditis,
• alopecia with diabetes mellitus,
• sexual disorders.

Seborrheic Alopecia

Under seborrheic alopecia mean hair loss due to skin disease of seborrhea. When seborrhea disrupts the sebaceous glands of the skin, which is accompanied by peeling of the skin and sometimes (but not necessarily) the cessation of hair growth or hair loss. In this case, the process is reversible, since the disease is not accompanied by the direct destruction of the hair follicles. There are problems with their functioning.

The following factors are believed to provoke the development of seborrhea and subsequent alopecia:

• poor nutrition,
• neglect of personal hygiene,
• hormonal drugs (including contraceptive),
• undertreated skin diseases
• frequent stress
• numerous trips (change of climatic conditions),
• hypothermia or overheating of the scalp.

Often, seborrhea appears in adolescence and is accompanied by the appearance of acne on the face. Also of the accompanying symptoms should be noted peeling of the skin (dandruff), itchy scalp, oily sheen of the skin. As a rule, these symptoms precede hair loss, which appears already in the later stages of the disease.

Diagnosis of Alopecia

In most cases, the patient himself notices that he begins to lose more hair than before. This becomes the first reason to contact a specialist. The doctor also conducts a comprehensive examination of the patient in order to identify comorbidities that could be the root cause of alopecia. After that, a number of specific analyzes and studies are conducted that help to identify the type of pathological process.

The full recommended examination of a patient with alopecia includes the following diagnostic measures:

• Visual examination of the affected area. With the help of a special magnifier, the doctor studies the area of ​​hair loss. It is necessary to check whether there are concomitant signs of skin lesions (desquamation, swelling, etc.). It is also important to find out if hair growth is observed.

• General blood analysis - to identify the level of red blood cells, white blood cells, platelets and erythrocyte sedimentation rate. These figures may deviate in case of systemic diseases and poisonings.
• Blood chemistry - with the obligatory determination of the level of ALT, AST, bilirubin, blood sugar (glucose), cholesterol and alkaline phosphatase. These indicators are needed not only for diagnosis, but also for the appointment of the correct treatment.
• Blood test for syphilis, to eliminate alopecia as one of the manifestations of secondary syphilis. Often prescribed with the appearance of multiple lesions on the head.
• Analysis of the level of the hormone cortisol - it is necessary to calculate the dose in case of hormonal therapy.
• Panoramic X-ray of the skull - as the cause of hormonal disorders may be changes in the pituitary gland. As a rule, the patient has other symptoms besides alopecia.
• Basic hormone analysis - thyroid stimulating hormone, prolactin. Changes in the level of these hormones also indicate problems with the pituitary gland.
• Microscopy of hair. For analysis, a patient is removed several hairs along the edge of the alopecia zone. After that, the specialist carefully examines the structure of the hair.
• Rheoencephalography (REG) - to determine the speed of blood flow in the vessels of the skull and brain. Slow blood flow can be one of the causes of alopecia areata.

It should be noted that in practice not all of the above studies are required. The attending physician first prescribes those that, in his opinion, will be more informative and less costly for the patient. Only in the event that the cause cannot be revealed with their help, are they transferred to more costly procedures.The application of all of the above methods is rarely required, but it can reveal violations and indicate directly or indirectly the cause of the disease in more than 95% of cases.

What doctor treats alopecia?

Diagnosis and treatment of alopecia are usually done by dermatologists or trichologists. In general, the area involved in the study of the hair and scalp is called trichology. This discipline is at the interface of medicine and cosmetology. Finding a good specialist can be difficult. That is why in the early stages, dermatologists are often engaged in diagnostics - specialists in skin diseases in general and its appendages (hair, nails). It should be borne in mind that if alopecia is only a symptom or manifestation of a skin pathology, then it is the dermatologist who will better cope with the treatment of the patient.

If necessary, specialists of the following profiles may be involved in the treatment of patients with alopecia:

• endocrinologists - in identifying hormonal diseases or disorders,
• immunologists - for correction of the immune system,
• rheumatologists - if alopecia has developed against the background of autoimmune processes,
• pediatricians - may be required for the appointment of complex treatment of alopecia in children,
• psychotherapist - when stress is detected as one of the possible provoking factors,
• nutritionists - are invited for consultation in case of malnutrition or identified metabolic disorders,
• cosmetologists - to correct cosmetic problems and hide the symptoms of the disease,
• psychologists - sometimes required by adolescents suffering from alopecia.

Thus, dermatologists most often become the first physicians to whom patients turn. Further, after establishing the cause of the disease, other doctors participate in the process.

Treatment of androgenic alopecia

Treatment of androgenic alopecia most often comes down to the use of hormonal drugs that block receptors for dihydrotestosterone or reduce its release. In this case, the treatment will be different for men and women. Doses of drugs and the form of their use are calculated on the basis of analyzes (according to the content of various hormones in the blood).

The following drugs are used in the treatment of androgenic alopecia:

• herbal preparations with antiandrogenic effect (chronostim, tricostim, 101G),
• minoxidil 2-5%,
• finasteride (for men) at 1 mg per day,
• Cyproterone Acetate - for women
• women can also be prescribed combined oral contraceptives Diane-35 or silest.

Such treatment must be taken for a long time, for several months. It should be borne in mind that taking hormonal drugs can give a wide range of side effects. Termination of treatment often leads to the fact that the hair begins to fall out again. Full recovery may occur if the level of hormones is changed due to pathology. If a genetic program is implemented due to aging, then to save hair, treatment must be taken continuously. It is also relevant after hair transplantation, as it protects transplanted hair from premature loss.

Treatment of alopecia areata

Treatment of alopecia areata does not always give good results, since the cause and mechanism of the development of this disease is not known. Most often prescribed prophylactic treatment of various disorders that could cause this disease. Supplemental immunotherapy and vitamin therapy are also prescribed.

When alopecia areata, the following treatment is prescribed:

• elimination of chronic foci of infection (caries, chronic tonsillitis or otitis media, etc.),
• B vitamins,
• multivitamin preparations (novofan, rewalid, fitoval, vitrum, etc.),
• immunostimulating agents (isoprinosine 50 mg per 1 kg of body weight per day, in 4 doses),
• glucocorticosteroid drugs - if indicated,
• PUVA therapy - hardware ultraviolet radiation treatment for 2 - 3 procedures per week,
• Dalargin intramuscularly 1 mg 1 time per day,
• zinc oxide or zinc sulfate - inside,
• Pentoxifylline inside 0.1 g twice a day,
• ointments and creams are used after stopping hair loss (vasodilators, cygnoline 0.5-1%, glucocorticosteroid ointments, minoxidil 2-5%),
• local betamethasone solution,
• sedatives for elimination of nervous disorders and intracranial pressure (prescribed by a neurologist after consultation).

As noted above, recovery may occur spontaneously, after discontinuation of treatment. Predicting in the early stages exactly when hair growth begins is very difficult. However, in young patients, sooner or later recovery occurs in 80–90% of cases.

Can alopecia be cured?

At the present level of development of medicine, it cannot be said that there are incurable types of alopecia. Most often, doctors can stop the pathological hair loss. Problems can occur with cicatricial alopecia, when the hair follicles themselves are destroyed or overgrown with connective tissue. Then the drug treatment will be useless, and will have to resort to hair transplantation.

Also, certain difficulties arise in the case of androgenic alopecia in men after 40 years. The fact is that hair loss in this case is usually genetically programmed and it is rather difficult to stop it. Long-term treatment with hormonal drugs, which are the most effective, can have many side effects.

Hair transplantation for baldness

As noted above, in many cases, the degenerative processes in the hair follicles are irreversible, so conservative treatment with medications does not give the desired effect. In this case, there is the option of a surgical solution to the problem - hair transplantation. Since the hair on the parietal and frontal parts of the head more often thin and fall out, usually small patches of skin from the nape of the neck are transplanted into this area. This flap is divided into separate strips and placed on the area of ​​baldness. Since the hair follicles on the donor flap are preserved, with successful transplantation, hair growth is preserved. This type of transplantation provides an even distribution of hair on the head and is effective for focal baldness.

Another option for transplantation is the follicular method. In this case, a special apparatus removes the follicles from the donor area and implants them into the alopecia area. So you can transplant hair to the head from other parts of the body. The effectiveness of this method in leading clinics reaches 95%. If we are talking about cicatricial alopecia, plastic surgeons first remove scar tissue in the area of ​​baldness, as it is worse suited for implantation of the follicles (it has fewer blood vessels).

When treating baldness with hair transplantation, the following disadvantages can be noted:

• the formation of scars and scars on the donor area during transplantation of skin grafts,
• hair loss in the first weeks after flap transplantation (however, when the skin takes root, after a few months, hair growth usually resumes),
• slight changes in the color of the follicular transplanted hair are possible,
• It is very difficult to transplant so much hair to ensure thick growth (not all follicles take root),
• follicular transplant method remains a rather expensive procedure,
• If you transplant hair by any method, but do not identify the cause of the initial baldness, then the hair will most likely fall out again.

What are folk remedies for hair loss?

There are many folk remedies that can help with hair loss from the scalp. However, their effectiveness in most cases is very relative.Alopecia can have many different causes, and each means of traditional medicine, as a rule, is aimed at eliminating only one of them. Thus, the use of these tools without consulting a dermatologist may simply be ineffective. For example, the use of nutritional masks does not make much sense if the cause of baldness is an infectious process, and vice versa.

However, in general, when figuring out the causes of hair loss and the correct choice of recipes, folk remedies can be very effective. Moreover, they are recommended by many experts in cases where the patient has contraindications (eg, allergies) for treatment with conventional pharmacological drugs. It is believed that garlic is one of the most effective remedies for baldness.

There are the following folk remedies based on garlic juice:

• Alternating gruel of pounded garlic and pounded onions. Gruel rubbed through the day, at night, covering the area of ​​hair loss with a thin layer of gruel.
• Aloe juice is mixed with garlic juice in equal proportions. After that add some honey. The mixture is rubbed into thinning hair before washing the head for 2 to 4 minutes. After that, wash your hair with regular shampoo.
• Juice is filtered from the garlic gruel. Further, depending on the type of hair (with beginning alopecia) add vegetable oil. Its volume should be from 10 to 50% of the volume of garlic juice. With dry hair, the proportion of oil is higher, and with oily hair - less.

Garlic contains essential oils, vitamin C, sulfur compounds and many other nutrients. They partly have a disinfecting effect, partly - nourish the scalp with essential trace elements. Due to this, hair follicles function better. However, treatment with these agents has a significant disadvantage. The specific repulsive odor becomes a problem for patients, as they have to apply this treatment for a long time.

The following medicinal plants are an alternative to garlic treatment:

• A decoction of burdock roots. The roots are folded into the pot and poured with water (until it covers the roots completely). The pot is put on a slow fire or in the oven and boil until the roots are melted. Then the broth is removed from the heat and stirred as it cools. The resulting mixture put on the balding twice a day.
• Sea buckthorn decoction. 100 g of sea buckthorn berries and 100 g of crushed young branches (with leaves) are ground into a homogeneous mass. 200 ml of boiling water is added to it and the resulting mixture is boiled for another 7-10 minutes. After cooling, the resulting mass is rubbed into the hair roots and left for half an hour. Then the mask is washed off with warm water. If hair loss is caused by a lack of nutrients or metabolic disorders, the result will be noticeable after 2 weeks of daily procedures.
• Infusion of calendula. Inflorescences of calendula pour vodka or diluted with alcohol in the ratio of 1 to 10. Infusion occurs in a tightly closed container for 24 hours. The resulting infusion is added to a glass of boiled water (1 tablespoon per glass) and drunk twice a day.
• Linden flowers. 5 tablespoons of linden flowers pour 1 liter of boiling water and cool. The resulting infusion rinsed hair after washing.

The above remedies can help slow the balding process. However, if the hair has already dropped out due to hormonal disorders or other pathologies, then these procedures will not have the desired effect. Then you should consult a dermatologist to clarify the causes of alopecia and begin drug treatment.

What is baldness prevention?

Since in many types of alopecia (for example, in alopecia areata), the causes and mechanisms of the development of the disease are not fully understood, there are no specific effective preventive measures.To reduce the likelihood of the disease should be attentive to hair care and try to eliminate various adverse factors that may weaken them.

The following recommendations can be attributed to the prevention of alopecia:

• regular hair washing using nourishing shampoos or other hair care products,
• wearing hats in cold and heat to protect the scalp from strong temperature effects,
• treatment of chronic diseases
• Avoid long-term medications that can cause alopecia,
• appeal to a dermatologist or trichologist at the first signs of excessive hair loss.

Since in some situations, these measures still do not protect against alopecia, and the treatment may be unsuccessful, you should also contact the specialists in the field of cosmetology and qualified hairdressers in a timely manner. They can help with changing the image so that the manifestations of the disease are less noticeable. When alopecia areata in adolescents may also require the help of a psychologist. It should be remembered that many types of this disease cause temporary hair loss, and recovery can occur spontaneously, at almost any moment.

What is the rate of hair loss?

In general, there is no single rate of hair loss that is suitable for all people. The fact is that hair loss and growth is a completely normal physiological process, which is influenced by many factors. This indicator may vary from day to day. On average, loss of up to 150 hairs per day is considered the norm, and the most healthy person inevitably still loses 40 to 50. However, exceeding the norm of 150 hairs does not always mean pathology.

When calculating the speed of hair loss, you need to consider the following features:

• in people with red hair, for example, the hair itself is thicker and falls out in smaller quantities than, for example, in blond hair,
• hair falls out faster with a sharp change in diet, while the body adapts to the new food,
• after a strong psycho-emotional stress in a person can fall into 2 - 3 times more hair, but this phenomenon lasts only 1 - 2 days,
• Counting hair loss is best done in the morning during normal brushing, because after washing your hair at a time, usually more hair falls out and the result will be biased,
• hair in other parts of the body fall out in significantly smaller amounts
• hair loss counting should not be done while taking antibiotics or other potent drugs,
• in winter in severe frost or in summer in the heat of the hair may fall more,
• hair dyeing, straightening, curling, or regularly pulling them into a tight bun or tail can also speed up one-time loss,
• after childbirth, the daily rate of hair loss is increased to 400-500, and it can last for several weeks.

However, in all these cases we are not talking about pathology, but about the normal effects of external and internal factors on a healthy organism. Of course, with a significant excess of the norm, it is nevertheless necessary to consult a dermatologist or trichologist. With their help, it is possible to estimate not the number of lost hair, but their changes. A careful analysis of a lost hair can tell a lot about pathological changes in the body. Normally, the hair does not fall out by the root, the tips of them retain their normal shape (they do not split, they do not split, etc.). The presence of these changes indicates the beginning baldness, even if the patient has up to 100 hairs per day.

Watch the video: Hair fall: Baldness due to Syphilis. Pankaj Oudhia (May 2024).