Congenital alopecia, or hair loss, is relatively rare.
It is characterized by full absence or drastic thinning of hair that can be combined with other disorders such as deterioration of nails, teeth, etc.
Premature, or presenile, alopecia occurs most often among young and middle-aged men and develops gradually.
In case with women it is generally limited to hair thinning. Hair loss begins in frontal and parietal areas. Then process grasps other sites of the scalp. The head-skin on the bald sites becomes thin, smooth and brilliant, and apertures of hair follicles are imperceptible.
Seborrheic alopecia, as the name prompts, develops on the background of seborrhea.
It is marked with abnormal sebaceous excretions and thinning of hair on the whole surface of the scalp, its peeling, and increased greasiness of hair.
Cicatricial alopecia presupposes constant destruction of hair follicles and their replacement by connecting tissue.
Cicatrices usually are not so visible as in case of healing wounds. They result in disappearance of apertures of hair follicles and the scalp becomes smooth and brilliant. The skin can remain soft and elastic though sometimes there may be callosities.
Areal alopecia, or alopecia areata, is characterized by loss of hair in one or several small sites on the scalp, underarms, on the pubis, beard, eyelashes or eyebrowes.
Such hair loss areas have more often round outlines, they can increase and merge among themselves, forming larger sites. The skin in the new-forming centers is slightly hyperemic and edematic. Later on it becomes smooth and gets the color of ivory.
Disease can proceed on the background of eosinophilia, lymphocytosis, regional lymphadenitis, thinning of nails, accompanied by headaches. In some cases total loss of hair on the head, and also loss of eyelashes, eyebrowes, and lanugo (malignant, or universal alopecia) is marked.
Hair can drop out during several years. Hair loss process can differ in intensity and duration. Sometimes children can have alopecia by way of small-focal "gleams" of hair or the coiled nimbus extending ribbonly from the nape to the auricles.
Most often therapy of premature alopecia consists in intensive bracing treatment. It can't result in restoration of all lost hair on the scalp, but it can reduce appreciablly the process of hair loss. Now techniques of operative treatment of hair loss, or alopecia, are developed. For example, hair transplantation in bald spots. This operation is carried out in specialized clinics and is rather expensive.
Hair losing women with hyperandrogenism are usually treated to eliminate the causes of the latter. In case of increased sensitivity to androgenes (male hormones) the nonspecific therapy that reduces their production by ovaries or blocks their peripheral effects is carried out. With this purpose oral contraceptives and spironolactone are applied.
Treatment symptomatic alopecia should be directed on the basic disease. In case of favorable outcome hair are restored and regrown in due course.
Treatment of seborrheic alopecia should be preventive. In these purposes besides bracing therapies and correction of metabolic processes intensive topical treatment is used. Complex treatment can warn or suspend loss of hair. Such therapy is carried out by dermatologists and cosmeticians.
In case of alopecia areata, or areal hair loss, treatment is generally out-patient or it can be carried out in dermatological hospital (when hair loss process is extensive and prolonged).
Vitamins A, E, C, H are used, as well as nicotinic, pantothenic and folic acids.
Also doctors resort to preparations of furocoumarin, sedatives means, ACTH (drenocorticotropic hormones) and glucocorticoids in such cases. The latter are also used exteriorly as ointments.
Rosental paste, alcoholic and etheric solutions with addition of sulfur, salicylic acid, tincture of siliculose pepper are applied.
Also irradiation by UV-beams or photochemotherapy is sometimes used in course of therapy. Among physiotherapeutic means used in alopecia treatment are d'arsonvalization, cryotherapy with snow of carbonic acid, cryomassage and massage with electrobrush.