BALDNESS[1] (technically alopecia, from ἀλώπεξ, a fox, foxes often having bald patches on their coats), the result of loss of hair, particularly on the human scalp. So far as remediable alopecia is concerned, two forms may be distinguished: one the premature baldness so commonly seen in young men, due to alopecia seborrhoica, the other alopecia areata, now regarded as an epidemic disease.
Alopecia seborrhoica is that premature baldness so constantly seen, in which the condition steadily advances from the forehead backwards, until only a fringe of hair is left on the head. It is always due to the underlying disease seborrhoea, and though it progresses steadily if neglected, is yet very amenable to treatment. The two drugs of greatest value in this trouble are sulphur and salicylic acid, some eighteen grains of each added to an ounce of vaseline making a good application. This should be rubbed well into the scalp daily for a prolonged period. Where the greasiness is objected to, the following salicylic lotion may be substituted, though the vaseline application has probably the greater value:—℞ Ac. salicyl. ʒi—iv; Ol. ricini ʒii—iv; Ol. ros. geran. m x; Spt. vini ad ℥vi. The head must be frequently cleansed, and in very mild cases a daily washing with soap spirit will at times effect a cure unaided.
Alopecia areata is characterized by the development of round patches more or less completely denuded of hair. It is most commonly observed on the scalp, though it may occur on any part of the body where hair is naturally present. The patches are rounded, smooth and somewhat depressed owing to the loss of a large proportion of the follicles. At the margin of the patches short broken hairs are usually to be seen. Clinical evidence is steadily accumulating to show that this disease may be transmitted. Organisms are invariably present, in some cases few in number, but in others very abundant and forming a continuous sheath round the hair. They were first described by Dr George Thin, who gave them the name of Bacterium decalvens. The disease must be distinguished from ringworm—especially the bald variety; but though this is at times somewhat difficult clinically, the use of the microscope leaves no room for doubt. It must be remembered that for patients under forty years of age, time alone will generally bring about the desired end, though treatment undoubtedly hastens recovery. After forty every year added to the patient’s age makes the prognosis less good. The general hygiene and mode of life of the sufferer must be very carefully attended to, and any weakness suitably treated. The following lotion should be applied daily to the affected parts, at first cautiously, later more vigorously, and in stronger solution:—℞ Acidi lactici ʒ i-℥ i; Ol. ricini ʒ ii; Spt. vini ad ℥ iv.
The loss of hair following acute fevers must be treated by keeping the hair short, applying stimulating lotions to the scalp, and attending to the general hygiene of the patient.
- ↑ The adjective “bald” M. E. “balled” is usually explained as literally “round and smooth like a ball,” but it may be connected with a stem bal, white or shining. The Greek φαλακρός certainly suggests some such derivation.