Alopecia - resistant or temporary lack of hair which can be partial (gnezdny baldness and its versions — cutting, focal, dekalviruyushchy with large pleshina, tape-like baldness of regional zones of pilar part of the head — ofiaz, and also more rare forms) or total. The etiology and a pathogeny of the majority of an alopecia are not found out. The disease is often considered as manifestation of a trophoneurosis. At some forms of baldness are necessary normalization of function of endocrine system (an alopecia at patients with a bazedovy illness and gipotireoidizy, with Itsenko's syndrome — Kushinga, at a pituitary cachexia, dysfunction of gonads), cancellation of hormonal contraceptives and other endocrine drugs (if they are not appointed according to vital indications) against which there was a hair loss. At some patients favorable (often temporary) effect of hormonal means (small doses of corticosteroids, anabolic steroids, sex hormones, Thyreoidinum, Pituitrinum), treatment by which carry out taking into account a hormonal background is observed.
At immunological changes appoint immunocorrective therapy (there is an opinion that gnezdny baldness — an autoimmune disease), according to indications — immunomodulators, means of a nonspecific immunotherapy (the pyrogenic drugs, etc.).
It is important to eliminate dysfunction of a nervous system at communication of an alopecia with psychoemotional experiences, an injury of the head and a neck, in particular with damage of the II cervical sympathetic node, nervous trunks, at vegetative frustration. According to indications appoint sedatives, tranquilizers, 2% novocaine solution on 5 ml every other day intramusculary (15 injections), vegetotropny drugs, and also Pyrroxanum; carry sometimes out hypnotherapy. In development of some alopecias the role of focal infections (a thicket in a nose, a throat), the general infectious and viral diseases (flu, toxoplasmosis, malaria, sepsis, a brucellosis, syphilis) is noted; the hair loss in these cases can decrease or stop after treatment of an infectious disease, sanitation of the centers of an infection. Carry out deworming.
At the alopecia caused by decrease in food, a hypovitaminosis, anemia apply fortifying means, biogenic stimulators: phytin on 0,25 — 0,5 g 3 times a day within 5 — 7 weeks (to children depending on age on 0,05 — 0,1 g on reception), aloe extract on 1 ml subcutaneously daily (20 — 30 injections) or inside aloe syrup with iron, placenta extract on 1 ml subcutaneously (30 injections), etc. Natrii arsenas subcutaneously on 1 ml of 1% of solution every other day is effective (20 — 30 injections). Apply inside arsenite potassium solution on 3 drops 2 — 3 times a day; an apilak on 0,01 g 3 times a day under language (10 — 15 days); Gumisolum on 2 ml intramusculary (20 — 30 days); Polybiolinum on 0,5 g in 5 ml of 0,25 — 0,5% of solution of novocaine intramusculary (7 — 10 days); a vitreous on 2 ml subcutaneously (10 — 15 days); FIBS on 1 ml subcutaneously (30 injections); Tincturas Araliae, a wolfberry, a magnolia vine, liquid extracts of a levzea, a rhodiola, an eleuterokokk, sterkuliya tincture (adaptogens do not use at the increased psychological excitability, sleeplessness).
At patients with the alopecia connected with dysfunction of a digestive tract (in particular, resorptive function of a small bowel), Enteroseptolum on 0,75 g/days is effective (15 days with a break of 7 — 10 days; E. N. Timoshkova, A. I. Sulzhenko).
Hair can drop out at seborrhea, an erythrosis and other dermatosis; in process of their treatment growth of hair is usually recovered (except cases when process comes to the end with an atrophy, for example, at a lupus erythematosus, a scleroderma). The alopecia is sometimes observed against reception of some medicines (cytostatic, anorectic drugs, sex hormones, anticoagulants, an isoniazid), and also after an anesthesia, under the influence of X-ray, intoxication (thallium, high doses of Retinolum), at frequent coloring and a chemical hairdressing.
The alopecia of inborn character is often combined with other defects of development (ektomezodermalny dysplasias). Its weight can fluctuate from moderate forms of a hypotrichosis to universal baldness of all general cover, including eyebrows, eyelashes, a down. Forecast of these of an alopecia adverse.
The physiological alopecia — at babies, teenage boys during puberty (in a forehead), does not demand from elderly people (a hydrocianic alopecia) of special treatment. Baldness can be owing to an addiction to pull out hair (the trichotillomania cases at the children, mentally sick requiring attention not only the dermatologist, but also the neuropsychiatrist), a long utyagivaniye of hair in a hard bunch at some types of hairdresses, rough combing of hair.
At the alopecia which is followed by cicatricial and atrophic changes of skin of pilar part of the head and other sites (a pseudopelade, a dekalviruyushchy folliculitis), development of hems as a result of permission of deep piodermichesky elements — furuncles, folliculites, for example, at a lupoid sycosis, treatment is, as a rule, ineffectual.
At the majority of types of an alopecia prolonged treatment, not always gives lasting effect. Widely use vitamins: Retinolum inside on 5 — 10 drops of 3,44% of Solutio oleosa 2 — 3 times a day; tocopherol acetate on 1 teaspoon of 5% of Solutio oleosa a day; thiamin on 1 ml of 5 — 6% of solution intramusculary in alternation with a pyridoxine — on 1 — 2 ml of 5% of solution intramusculary (3 — 4 weeks) 5 pyridoxal phosphate on 0,02 g 3 times a day; Riboflavinum on 0,005 g/days; cyanocobalamine on 500 mkg 2 times a week intramusculary (15 injections); nikotinamid on 0,025 g 2 times a day; calcium pantothenate on 0,1 g 3 — 4 times a day; calcium pangamat on 0,05 g 3 — 4 times a day; biotin (vitamin N, improves a skin trophicity, promotes utilization of thiamin, acids folic and ascorbic in an organism) on 150 — 300 mkg/days parenterally; ascorbic acid on 0,5 g 2 times a day; vitamin F, and also polyvitaminic drugs.
If necessary use proteinaceous drugs, amino acids (methionine, cysteine). The massage of pilar part of the head strengthening a hyperemia for 10 — 15 min. (with capture of skin of a neck, area of mastoids and an upper back) daily or every other day is shown (15 — 20 sessions). Bukki-terapiya is sometimes effective. At the increased lymph nodes (cervical, submaxillary) skin over them and around them grease with medicines in Dimexidum (antibiotics, 10 — 20% Ichthyolum solutions, solution of iodine of spirit 2 — 5%) that it is possible to combine with the physiotherapeutic procedures having the warming, resorptional, antiinflammatory effect (Ural federal district, a diathermy, fonoforez).
In food limit amount of table salt, include gelatin, enough the vegetables, fruit, products rich with phytin in a diet (a liver, kidneys, a brain, fish, bean, citrus, milk, grains of cereals), biotin (a liver, kidneys, bean, yeast, potatoes, milk).
At an alopecia local therapy has extremely important value. In the baldness centers vigorously rub spirit solutions of various means, ointments. The local irritative means improving blood circulation, a trophicity are effective: tincture of pepper siliculose, kapsitrin, linimentum pepper and camphoric, juice of garlic, onion, gruel of a nonsense, 2% spirit solution of essential mustard oil, etc. Apply also the ointments containing amino acids (gelatinous cream), 3% apilakovy placental, "Edcamonum", and also 3% spirit solution of propolis or 10% ointment with this substance ("Propotsium"), apizartron, the spirit solutions, ointments, creams containing 5 — 10% of sulfur, 5 — 15% of tar, 2% of salicylic acid, 3 — 5% of resorcin, 5 — 10% of Chlorali hydras, 3 — 5% of bile of medical, 1% solution of a minoksidin, furocoumarinic drugs (0,5 — 1% solution of an ammifurin, 0,25 — 0,1% solution of a beroksan), ointments "Psoriazinum", "Antipsoriatikum", the dosage forms containing 0,1 — 0,5% of trimetilksantin (caffeine, theophylline, theobromine). It is reasonable to use a plaster pepper (medicamentous means on the basis of plasters have deeper and long effect, than as a part of other dosage forms). The balneotherapy is recommended.