Hair loss is separable into two major categories: that which occurs with associated scalp disease and that which occurs in absence of scalp disease. Under Tinea Capitis, the hair loss is characterized by the fact that the hair is broken off at, or close to, the surface of the skin. This results in the presence of fine stubble which if too short to palpate is sometimes visible as a series of black dots within the patch of alopecia. The patches of alopecia in tinea capitis are also characterized by their sharp margination and their confinement precisely to the area of scalp disease. The associated scalp disease consists of a sharply marginated scaling plaque with varying degrees of inflammation. Infection with M. audouinii and T. Tonsurans may be relatively noninflammatory whereas those due to M. canis and T. mentagrophytes may be accompanied by postulation around some of the dollicles. Only the Microsporum infections fluoresce underWood’s lamp illumination. Confirmation of a suspected I instance of tinea capitis depends on performance of KOH preparations and fungal cultures. Treatment of tinea capitis is almost always accompanied by complete regrowth of hair. Under Lupus Erythematosus, localized patterns of hair loss regularly develop when lesions of discoid lupus erythematosus occurs in the scalp. Here too the hair loss is very sharply localized. Hair loss also occurs in systemic lupus erythematous but it is more diffuse and is often unassociated with scalp disease.
The underlying scalp disease is that of a mild inflammatory, scaling process. The amount of scale varies with the frequency and vigor with which the patient shampoos. Seborrheic dermatitis of the scalp severe enough to result in hair loss is generally accompanied by seborrheic dermatitis of the retroauricular and nasal folds. Alopecia associated with seborrheic dermatitis may be continuous but it is not progressive. For this reason visible baldness should not be ascribed to sehorrheic dermatitis; Hair regrowth occurs when seborrheic dermatitis is adequately treated. Syphilis of many months duration often develops a peculiar pattern of patchy, “moth eaten” alopecia. The large number of patches, their smaller size and their indistinct margins help to separate this condition from that of alopecia areata. Both men and women may develop a distinctively pattern type of hair loss as according to age. In men the loss is most noticeable at the vertex and in the bitemporal regions of the scalp. In women the loss is usually restricted to the vertex. In both sexes’ women overall diffuse loss may also occur. Pattern loss may be seen as early as the third decade in men but is rarely apparent prior to the sixth decade in women.
Treatment consists of finding the cause and its elimination reassurance and improvement of general health with good nourishing diet, vitamins and minerals. In debilitated individuals, Alfa-Alfa mother tincture can be given. A quite relaxing holiday is very beneficial. Local treatment consists of: avoid repeated and too frequent combing and shampooing; excessive use of oil and oily preparation, especially in seborrhoeic individuals; light massage of the scalp with special prepared with homeopathic medicine.