The extracts of the aloe vera plant have a complex set of chemicals with the ability to suppress and stimulate the immune system in a number of ways. There are reports of clinical trials, of varying quality, suggesting that aloe vera has a positive effect on wound healing, immune stimulation, aalso aginast cancerc and in the treatment of various viral conditions. There is also a recent report of its effectiveness in the treatment of psoriasis.
Anthralin is available as a greasy ointment (Anthraderm) and also as a non-greasy vanishing cream (Dritbo, Lasan). Whether drithocreme or micanol (types of anthralin) are more effective, if at all, is unclear to me. Studies show anthralin works from 0-82% of the time! It is applied to the bare patches once daily and washed off after a short time, usually 30-60 minutes later. If new hair growth occurs, it is seen in eight to twelve weeks.
According to Mosby's diagnostic and laboratory test reference, "Microsomal antibodies are produced in response to microsomes escaping from the epithelial cells surrounding the thyroid follicle. These escaped microsomes then act as antigens and give rise to antibodies. These immune complexes initiate inflammatory and cytotoxic effects on the thyroid follicle. This test is usually performed in conjunction with the antithyroglobulin antibody test."
The problem with having a disease characterized by antibodies against nuclei is that ALL cells of the body have this structure. The disease may therefore affect the brain as well as the kidney, or the joints. In other autoimmune conditions the antibodies are directed against a portion of a specialized cell and may therefore be restricted to a specific tissue type (e.g., skin).
“I'm still using the aromatherapy oil on my head. Smells better than olive oil. I really don't know how much difference either actually makes, but I do have an itching problem in my scalp as well, and the aromatherapy soothes the itching somewhat.”
An article about aromatherapy and alopecia appeared in Natural Health September/October 1997 issue. In the article, a women who suffered from AA since children and was losing all of her hair, recounted her use of aromatherapy and cayenne extract. Each night before bed, she massaged a mixture of lemon, lavender, rosemary and carrot seed essential oils in a base of jojoba oil into her scalp (no information as to the total amount of each mixed was provided). In the morning, she stimulated her scalp with cayenne pepper extract and a soft toothbrush followed by rinses of hot and cold water. She claims to have seen regrowth in about three months and had a full head of hair after six months. She has not had a recurrence of alopecia since beginning her therapy.
In "The Complete Book of Essential Oils and Aromatherapy" by Valerie Ann Worwood several recepies are recommended using oils:
Blend ingredients together in a bainmarie and use the shampoo once a week.
Blend the ingrediants together and massage into scalp. Leave on the hair at least 30 min. before washing off.
Every night apply the following treatments all over the scalp. Mix together and store in bottle. Use 1 teaspoon for each application diluted in 1 tablespoon of cold cold water. This one doesn't smell to great and your husbands/boyfriends may not want to sleep next to at night
In the book it states, "Essential oils, and indeed many nut oils can stimulate the hair follicle and increase circulation and oxidization sufficiently to bring regrowth of hair, although in some cases this may resemble vellus or baby hair".
Some of our members have used the following recipe with some success:
In a small amber glass bottle, add the jojoga oil and carrot seed oil. Add the essential oils and shake to mix. Label. Warm the oil before application by placing it in a warm water bath. Apply by massaging a few drops into the scalp area. Leave in to be absorbed. Apply several times weekly.
Note: Small amounts of essential oils are used with the same amount of carrier oils for children. Example: where ever you read essential oils you must cut drop amount in half. Rosemary would then be 2 drops. Carrot seed oil is hard to find, expensive but a very good oil for hair problems. Calendula oil must be made by infusion (made from actual herb sitting in olive oil in the sun for about three weeks, shake from time to time.
Of related interest is an extract from the book "Herbs: Their Cultivation and Usage":
For people with sensitive skin some great non-irritating soap recipes can be found in Sandy Maine's "The Soap Book". One of the recipes is made of lavender and rosemary essential oils and comfrey root powder.
The scientific community has joined the aromatherapy bandwagon. A recent article by Hay, Isabelle, et. al. "Randomized trial of aromatherapy: successful treatment for alopecia areata." Archives of Dermatology. Vol. 134. November 1998. 1349-1352 focuses attention on this possible therapeutic intervention. The researchers in the study used a mixture of cedarwood, thyme, lavender, rosemary, jojoba, and grapeseed oils. The mixture was massaged in the scalp of patients every evening for two minutes. A placebo control group received only jojoba and a grapeseed oil mixture. To be honest, when you have a good look at the study, there are holes in it, and the title of the article is a little over optimistic. It does not mention how long people had areata, how they randomized the groups, and whether or not they had other associated disorders. Sometimes aassociated conditions (such as thyroid disorders) are a factor in a positive or negative outcome.
For those people who have tried aromatherapy, it smells too much and doesn't work all that well. What they would like is aromatherapy without the aroma!!! Additional information about this therapy can be found in a newsletter called The Integrative Medicine Consult (February 1, 1999 Volume 1, Number 4). If you would like to try it the following are some suggested dosages:
Avoid using red thyme, one of the various types of thyme. This is a potent counter irritant and will burn the scalp. This kind of thyme used with one of the better (more expensive) and more irritating forms of rosemary causes scarring. Of the scarring types of thyme- one drop can be used per 20 ml of carrier oil. Several of the inexpensive forms of rosemary are recreational but do not have the therapeutic benefits found in some of the other more potent forms. These forms may not be specified on the bottles of oil.
You may try rubbing the solution into the scalp for two minutes each day and then a warm towel or other covering is applied on top for 10-20 minutes. The scalp is not washed for at least four hours after.
Belle Star Inc 23151 Alcalde Laguna Hills, CA 92653
But an even better source is:
Yerba Buena 1809 Fourth Street Berkeley, CA 94710
The above is a "purveyor of herbs, spices, teas, essential oils and aromatherapy accessories". They do mail order, but they don't have a catalog of their goods. Phone # is 510 548-3500.
Note: People with high blood pressure, epilepsy and who are pregnant should not use aromatherapy.
--See also section 6 under Other Problems: Changes in Skin Pigmentation.
The association of multiple endocrine disorders in the same patient prompted Blizzard, Maclaren and Neufeld to use of the term Autoimmune Polyglandular Syndromes (APS) for these conditions. Their Type I APS may be seen in young adulthood or early childhood and has an equal incidence in both males and females. It is comprised primarily of three primary disorders- Addison's disease, hypoparathyroidism and chronic mucocutaneous candidiasis. The prevalence of these associated disorders has been summarized as follows:
| Endocrine disorders | |
|---|---|
| hypoparathyroidism | 90% |
| Addison's disease | 60% |
| Gonadal failure | 45% |
| Autoimmune thyroid disease | 10% |
| IDDM (insulin dependent diabetes mellitus) | 1% |
| Nonendocrine disorders | |
| mucocutaneous candidiasis | 75% |
| malabsorption syndromes | 25% |
| ALOPECIA | 20% |
| pernicious anemia | 15% |
| chronic active hepatitis | 10% |
| Sjorgen's syndrome | 5% |
Type II APS is the more common type of polyglandular failure. It is seen at all ages but more commonly in adults. There is a strong female predominance and often there are family members with similar manifestations. The most common endocrine abnormalities in this group include Addison's disease, autoimmune thyroid disease, and IDDM. Common nonendocrine type of manifestations include ALOPECIA, vitiligo and premature greying of the hair. (For more information see WJ Riley Horm Res 38(suppl 2):9-15, 1992.)
The following is a letter writen to me by a patient suffering from this condition:
Hi! I am contacting you after having read your letter about your daughter's hairloss and how it has inspired your research. I am very moved, to say the least. I am a 37 year old woman, living in Los Angeles where I was born. I was exposed to DES (Diethylstilbestrol) in utero and now suffer from multiple autoimmune endocrinopathies. (at least 7 different types). I have had brief periods where I have experienced excessive hair loss, though always with regrowth immediately afterwards... this year I have lost more hair than ever before and i am developing bald spots where no new hair seems to be sprouting. It is a very traumatic thing to have to go through, although I am less concerned about my appearance than I am about my health. I have not been seen by a Doctor (regarding my autoimmunities) since I was "turned loose" from UCLA's medical research center 17 years ago... I was molested by a Doctor during my first year there as a patient/oddity along with having been a "guinea pig" or a living cadaver to be poked and probed with no consideration for the frightened teenager lying naked on the table. Two years ago I took a fall on some steps and broke my wrist. The osteopath who treated me discovered that my bones (after 2 months in the cast) did not seem to be fusing, or were healing at an extremely slow rate. It was then that I discovered that I was in the advanced stages of osteoporosis. I have beeen unable to get any kind of health insurance...am presently on state disability (as I am manic depressive and suffer from severe attacks of panic and anxiety) and when I look ahead to what the future may bring, I see nothing....and it is such a strange thing to live without any hope whatsoever. I am not so much afraid as I am lost. The Doctors at UCLA had placed me on estradiol and provera, which, as I told them, caused me to feel as though a war was taking place within my body. I was experiencing more extreme highs and lows than I'd ever known (which is truly saying something!!) and yet, was told consistantly by one Doctor after another that the replacement hormones "should be making me feel better"...as though I was not cooperating.!! Finally, I just gave up. I took it upon myself to stop taking the hormones as well as the advice and mental abuse I had come to expect from all Doctors. I am not sure what I'm asking for here... I don't know what I want or even that I COULD want for something...I just maybe want to be heard without being told that I am wrong or that it is my fault that I don't respond well to the medicines I've been given. I do have one hope and that is, that by hearing this, perhaps it will contribute somehow, a bit more information, to your research. So...I guess I DO have some hope alive within me, after all...Please feel free to share any of this letter with your daughter, if you feel it would be of any benefit to her. If nothing else, she might understand that she is not alone... If she needs or wants to communicate with me, I would welcome it!
Male pattern baldness is where the bonding method works best. Those of us with AU and AT should never bond hair as we do not have the hair to which the bonding glue can be applied. I do not suggest that it be used for AA for two reasons. First, the fall out pattern of AA is unpredictalbe and the bonded hair may be gone tomorrow. Second, the existing hair is in such a fragile state and putting excess stress can excelerate the loss.
In some cases the bonding method of hair replacement can be used for women with androgenetic hairloss. My only caution with this method is the excess stress it places on the existing hair. It is important with thinning hair that the attachment (bonding, clips, tape) be rotated to give the existing hair a rest. Continued use of attachments will cause traction hairloss.
There is an interesting article by Matthysse et al. (J Psychiat Res 26(4):461-473) written from the mental health perspective that recommends various "bootstrapping" techniques to "turn non-Mendelian into Mendelian phenotypes." One of the techniques (detailed in Matthyse and Parnas J Psychiat Res 26(4):329-44) is to expand the phenotype in order to increase the number of persons with the condition. The assumption is that a "minor" gene for the disorder may be a "major" gene for something else, eg, a minor gene for eczema may be major gene for alopecia areata.- I do believe that the most parsimonius model for alopecia areata is one where several genes interact with one another to produce the BSAAS.
One way to offer suggestive evidence for this was of thinking is to make a survey among our participants and divide them into 2 groups. One group would have only one person affected and the other group would have at least two persons (brothers/sisters/brother-sister/children) affected. Finding a higher prevalence of atopic disorders in the parents of those families having two siblings affected would suggest that the broader phenotype is a manifestation of the same genetic liability.
Changing our diet can lower the levels of Candidiasis, by avoiding some foods and adding some supplements like essential fatty acids (flaxseed oil ect) and garlic oil suppresses the Candidiasis growth.
The CD4/CD8 ratio is widely used in clinical practice although the values themselves have to be standardized for each laboratory. A low number may signify that your CD4 lymphocytes are low (as in AIDS) or contrariwise that the CD8 cells are in overabundance (e.g., an infection with EBV, hepatitis B virus, or even cytomegalovirus). There are at least a dozen or so publications on the subject of CD4/CD8 ratio in alopecia areata. The results have been somewhat variable. One possible explanation is that some studies compared apples and oranges including in their analysis active patients along with those in remission. Our own study showed that in patients with active alopecia areata (proven by biopsy) this ratio is increased. Other studies have led me to believe that it is due to the combination of both an absolute increase in the number of CD4 cells and a diminution in the CD8 cells.
In the April 3, 1996 Journal of the American Medical Assn a study appeared that associates alopecia areata and celiac disease (see also: Celiac disease and alopecia areata: Report of a new association", Corazza G, et al. _Gastroenterology_, 1995, vol. 109, 1333-1337). The treatment for celiac is a wheat-free, gluten-free diet. This was tried on a fourteen year old boy with aa, and it resulted in full regrowth of head and body hair. The study showed that three patients who were asymptomatic for intestinal disease but had aa tested positive for celiac disease. The study suggests that aa may be the only clinical manifestation of the disease and recommends that antigliadin and antiendomysial antibodies should be included in the work-up of patients with AA.
Apparently many people are allergic to glutenous products. This is probably due to the fact that we tend to overuse gluten in our American diet. Gluten includes wheat, oats, barley and rye. Gluten is the component in these products that makes them sticky, allowing them to be kneaded into breads. Alternatives to these grains include amaranth, quinoa, millet, buckwheat, rice and corn. Also, teff, spelt and kamut have low levels of gluten and may be tolerated by some. Although wheat and gluten are tough to avoid in processed foods and in restaurants, it's not that difficult to avoid with fresh foods you make yourself.
Avoid:
Lots of good stuff you can still eat: vegies, fruit, dairy products, rice cakes. Of course, the more other things you don't eat (like dairy products, meat, sugar, etc), the harder it is. You can eat dairy products, but not red meat. Not eating pasta is the hardest -- but there is pasta made from vegies (like Jerusalem artichoke hearts) in health food stores. It is certainly true that you have to read the labels because "soy protein" which can contain wheat seems to be in everything, also caramel and malt flavoring. Some ice cream even contains the stuff. Because so many people are allergic to gluten, there are a wide variety of products available ("wheat-free" or "gluten-free") that can be found at health food stores. A catalog containing wheat-free and gluten-free bread mixes and related things is produced by Wilde Temptings (1-800-434-4846). Bette Hagman has great "gluten free gourmet" cookbooks which have recipes for gluten free deserts and breads you can make in a bread machine. Remember that there are flour replacements such as rice flour, potato starch flour, tapiocca flour and more. You don't have to do without good food.If you would like to know more about celiac disease a good web site to visit is www.celiac.com.
Dr Daly's research has focused on examining the blood plasma levels of the vasodilator/immunomodulator CGRP (Calcitonin Gene-Related Peptide) in people with alopecia areata. He took serum samples from 18 people with alopecia areata and 69 control samples from people without alopecia areata. The serum samples were analysed using a technique called "radial immunodiffusion" (RIA). This is a simple technique to define concentrations of biological substances in solution. Dr Daly found that in people with alopecia areata the concentration of CGRP in the plasma was about half (53%) that of control samples.
Dr Daly suggests that this apparent lack of CGRP could have an important influence on alopecia areata development. He believes that without the vasodilatory properties of CGRP there may be a reduced blood flow to hair follicles and this may result in dystrophic hair follicles less able, or unable, to produce hair fiber. In his own words (from a post to our list server): "AA may be autoimmune in nature, but I believe that CGRP, a potent vasodilator and immunomodulator, is first decreased in patients with AA. We have shown lower serum levels and other researchers have shown lower tissue levels. The low CGRP causes the hair to grow poorly due to decreased blood supply and allows the immune aspects of the hair to be exposed due to lowered immune protection by CGRP. I call this the 2 steptheory-1)low CGRP 2) immune response. I believe both aspects must be corrected to have hair regrowth." He also suggests that lack of blood flow may also account for nail pitting, eczema, and pigmentary abnormalities.
CGRP also has immunomodulatory properties and apparently suppresses antigen presentation to lymphocytes and slows down their proliferation and reactivity. This suggests that people with a deficiency of CGRP may have a greater susceptibility to inflammatory reactions as occur in alopecia areata. Calcium, nicotine, caffeine as well as steroids and pregnancy increase CGRP levels
Dr Daly believes that this deficiency in CGRP shows that people develop alopecia areata as a result of deficient thyroid production and that the autoimmune hypothesis of alopecia areata development needs to be modified or may be entirely wrong. He believes that using treatments directed at replacing and/or increasing levels of CGRP in the blood stream of people with AA may be an effective promotor of hair regrowth.
Some comments would be:
References for CGRP in AA include:
Rossi I et al. Neuroreport. 8(5):1135-8, 1997
Daly T. Archives of Dermatology 134,1164-5,Sept 1998
Mijalovic B. V Pregled 54(1):31-3. 1997
Daly T. Journal of Investigative Dermatology June 1999
Atkin D JAAD 37(5).Pt 1, 796-7, 1997
The herbs used in the systemic treatment are usually complemented by drinking lots of water. Systemic treatment consists of mixing equal portions of Rhizoma seu Radix Noptergii, Fructus Chaenomelis lagenariae, Rhizoma Gastrodiae, Radix Paeoniae albae, Radix Angelicae sinensis, Semen Cuscutae, Radix Rehmanniae conquitae, Radix Ligustici walchii, and grinding them into powder. The powder is mixed with honey to make pills the size of a "Chinese parasol tree seed". The pills are taken 4 to 6 twice or thrice per day for about 6 months. The alopecia pills and information of the same can be obtained through the Net at chiherbs@primenet.com. The pills are fairly inexpensive $2.75 a bottle (100 per bottle). That is about $15 per month. Stores may sell a similar preparation under the name of Shen Min Hair Nutrient. You may also want to review the definition of Trichogen elsewhere in this Dictionary.
The accupuncture practiced by Chinese medical professionals involves several different steps. First, the practitioner applies a lotion to the scalp. The lotion contains herbs (mostly ginger but Westeners use cedar, sesame, olive or eucalyptus oils) in ethyl alcohol. Ginger contains phenol, a chemical compound previously used in the treatment of alopecia areata. Phenol acts as an irritant and may increase blood flow to an area. These are massaged directly into into the scalp where hairloss is occurring once or twice daily.
Next, the practitioner use a tooth pick or needle to poke on the AA patch without piercing the skin. Traditional accupuncture uses a "7 star needles" that looks like a hammer with 7 needle but has a flexible handle. This instrument is also called a Chinese dermal hammer (a small hammerlike device, usually made of lightweight plastic or metal which has one end a simulated hammer about a half inch in diameter with many fine protruding needles (OUCH). This instrument has also been used in other dermatological conditions including psoriasis, eczema, certain rashes and wrinkles.
The scalp is tapped slightly with the 7 needles especially around the edges of the lesions. The poking effect may, again, be similar to other irritants been used on AA. It is used to "awaken the nerves" and improve blood flows. Lastly, the practitioner presses his thumb hard on the AA patch and rocks his thumb for a few minutes without pulling out any hair. This, again is again done to improve the blood circulation. Overall, visits should cost between $10 and $30. Anybody trying to slap a $50 tab on you each time are way over priced. Treatment may last anywhere from a few weeks to a few months depending on the severity of the condition.
There is an interesting article detailing the use of traditional Chinese herbal therapy in atopic dermatitis. As you are already aware AA and atopic dermatitis are often seen coexisting in the same patient. The study reported clinical improvement of the condition but pointed out that given the number of herbs and different active ingredients it was difficult to discern a mechanism. The authors also found that their concoction was potentially toxic and could produce liver damage. (Sheehan M, et al, Efficacy of traditional Chinese herbal therapy in adult atopic dermatitis. Lancet 1992, 340:13-17).
Another use of Chinese herbal therapy is in restoring hair pigmentation (e.g., premature graying). The use of He Shou Wou supposedly nourishes liver and kidney essence thus making the hair darker. The name of the herb comes from an ancient story of a famous military leader who was condemned to death by confinement in a remote cell without any food or drink. He was able to survive by consuming the leaves and roots of an accesible vine-like weed (polygonum multiflorum). After one year his keepers went back to collect his remain only to find him completely rejuvenated with lustrous black hair. Since that time the herb has been named in his honor (He Shou Wou). The herb may be found as an ingredient in a patented formula called "Shou Wou Chih" or Fo Ti. Another remedy for restoring hair color is black sesame seeds (one tablespoon daily). The seeds are roasted and ground with salt to make a condiment or mixed with honey or powdered sugar for a sweet version. See the article Integrating the Traditional Chinese Understanding of the Kidneys into Western Herbalism by for more information (especially section 8).
Note: The terminology of Chinese herbal remedies may be somewhat confusing. Fo Ti, Shou Wu, He Shou Wu, Radix multiflora polysomething or other... are all the same. Trichogen and Shen Min contain Shou Wu (amongst other ingredients.)
Fitzgerald DA, et al. (1995) Spa pool dermatitis. Contact Dermatitis 33:53.
See also section 6: How do I take care of my skin?
I am sitting at the breakfast table reading my newspaper when a picture on the first page draws my attention. A young distinguished scientist was caught performing fraudulent clinical trials and is being sent to prison. Fifteen years in jail and 15 year probation has been the harsh sentence. A plea bargain has allowed him to retain some personal possessions otherwise disputed under the Ricco statues.
I raise my eyebrows. Uhhmmmff.
A hazelnut aroma suffocates me. I pause to sip discretely the coffee that my wife has placed in front of me.
"The details of this remarkable schme have been found within the archives of the FDA", quotes the newspaper.
I wipe my lips with a handkership that had been tucked in between my wallet and my pocket.
"The FDA is an ancient organization originally derived from the Fumbling Dictographers Association. It was a group of federal employees that because of their tenure could not be fired but, rather, were clustered together and isolated from otherwise better employees. The incept was based on the dictum, "if you can't fire them, give them good recommendation so that they can move to another job."
The organization was charged by President James Garfield with the responsibility of copying a series of Spanish transcripts that dealt with the history of malaria. Unfortunately the President was assasinated before seeing the end result of his mandate. Unable to read or speak Spanish, the FDA labored at copying over and over the original text and misattributing its authorship. The recreated text gave rise to Gorjas manuscript on malaria. By means of a singular series of mistakes the text was transformed to an epistolary narrative on polio. Eventually, accumulated errors gave rise to the use of steroids in alopecia. Sensitizers and irritant were different interpretations for a term the FDA had originally translated as skin tenderizer."
I sit, amazed by the newspaper account. No wonder I always confused DPCP with DNCB. SABDE was just more gibberish.
I felt sorry for the investigator that was sent to jail. The FDA in mistranslating the original text may have inadvertently attributed authorship to the wrong person.
I signal my wife with my hand to call her attention. "You see Gisela," I said imperturbably, "Although there are many clinical trials in alopecia they are all rehashed versions of one that never even attempted to find a cure for the condition."
Teaching point: Wouldn't it be nice if the cure for alopecia is found from experiments designed to treat or cure alopecia rather than high blood pressure, prostate dysfunction, glaucoma, organ rejection, etc?
The following is an excerpt, loosely translated, from a TV news broadcast in Turkey:
“A catastrophic event would nearly happen in Bulgaria when the Head of the Balds' Association was caught with a COMB in his pocket. The man was going to be removed from the Association as it was forbidden to carry a comb according to the rules of their association. The man could only convince the members not to remove him by saying that he was carrying the comb for his moustache!”
Well there is one advantage of not having hair; you can't get the cooties. Otherwise if you have them, treatment is easily instituted through the use of lindane (Kwell) or "synergized pyrethrins" such as R.I.D. An alternate therapy may be a very painful innoculation. Sometimes a shoulder punch will work, but the proven method is a good hard pinch. Corticosteroid injections, as always, exacerbate the condition. Is there a point in being weird about things that don't exist? Well, maybe just in having fun. (Hopefully this dictionary and its definitions are cootie free!)
The whole point of the article is that fairly innocous application of steroids may be absorbed even when they are not injected. I have heard that a clove of garlic under the foot inside your shoe will soon start to smell on your breath. I haven't tried it myslef but if this were the case it would attest to the absorbance capacity of the skin.
The article by Wells and Brodell suggest a similarity between the flare ups of the conditions treated by topical steroids and alopecia areata. It is apparent that after repeated aplications, the steroid controlled the immediate manifestation, but ended by making the underlying condition worse in the long run. An interesting point (as basic as it sounds) is that at present we don't have a study comparing the long term outcome (20 years down the road) of patients treated with steroids vs. those that didn' receive them. Who knows maybe the majority of our participants never recovered because of the aggresive treatment they may have received early in life? Maybe those that didn't receive medication have recovered and therefore are not within our list server. These are emphatically a concatenation of loose ideas but may serve as food for thought.
Couvre works well and makes the bald patches less conspicuous if you have hair to comb over the bald spots. Presumably the product is safe to use even if you are already putting some kind of topical medication on your spots.It doesn't run, even in the rain, even in the shower, even if you sweat. It needs to be washed off with shampoo or soap. Some people apply it by rubbing it onto the salp with a couple of fingers although it comes with an applicator sponge. Wash your hair, comb it out and then apply the Couvre before blow drying. It is somewhat messy and will stain pillow cases and sheets if you don't wash your hair before bed. Also, if you don't wash your hands with soap after application then it rubs off on whatever you touch.
Some people have also used mehndi tattooing as a way to cover the bald spots. The method only provides for temporary results. You can read more about mehndi in section 5 under Wig Alternatives.
Searching medline I found a recent article which from the title sounds like eliminating gluten does not always result in regrowth of hair:
Bondavalli P; Quadri G; Parodi A; Rebora A. Failure of gluten-free diet in celiac disease-associated alopecia areata [letter]. Acta Dermato-Venereologica, 1998 Jul, 78(4):319.
You may also want to check the following article:
Corazza GR; Andreani ML; Venturo N; Bernardi M; Tosti A; Gasbarrini G. Celiac disease and alopecia areata: report of a new association. Gastroenterology, 1995 Oct, 109(4):1333-7.
“I took cyclosporine pills for 4 months but the result was totaly negative. Now that I haven't taken anything for a year and half I am experiencing regrowth. What kind of crazy contition is this?”
An immunosuppressive agent derived from fermentation of a soil fungi (Tolypocladium inflatum Gams). The drug affects the activity of certain types of immune cells (helper T lymphocytes) without affecting others (suppressor T lymphocytes, B lymphocytes, macrophages, etc.). It has been used extensively in medicine to prevent transplant rejection, less so in psoriasis and rheumathoid arthritis.
Although it has been reported that some severe cases of alopecia areata (including AT and AU) have shown regrowth when treated with the drug, its toxicity prevents widespread usage. Some side effects of the medication include renal failure, hypertension, liver damage, an increased susceptibility to infections, tremors, etc. The concentration of cyclosporin can be increased by drinking grapefruit juice, taking oral contraceptives or calcium channel blockers. As one of our lady participants said you could probably obtain better results with less side effects by putting the hair above her lip (that she bleaches) and the hair between her eyebrows (that she plucks) glued to her forehead.
The original report by Dr skinner suggested CMV was found in or near hair follicles in people with AA. Dr Skinner tested a small number of skin biopsies and consistently found CMV for biopsies of AA affected skin versus biopsies taken from people with other skin disease. He suggested CMV might be causing inflammation which led to hair loss. There is a seperate report on injection of CMV into mouse skin causing localised inflammatory alopecia around the area of injection.
Three different research groups tried to repeat Dr Skinners findings but failed to identify CMV in hair follicles from their biopsies. I think one group used in situ hybridization techniques and the others examined for DNA derived from CMV. It is thought that Dr Skinner was either just "lucky" in finding CMV in all of his samples or he had a problem with CMV DNA contamination in his laboratory.
This is a powerful steroid which may provide the precursor for androgen and estrogen in peripheral tissues. There have been many uses for DHEA reported in the medical literature. Among the ever increasing list are its use to restore immune competence in aged animals, prevent atherosclerosis, in aging (restoring some cognitive functions) inhibit platelet aggregability, prevent cancer, and even as an antidepressant. In the layman press DHEA has been said to promote a sense of well being, improve sexual function and grow hair.
I have some concerns based on the fact that the drug has been tested primarily in animals and we don't know its complete range of side effects. I still believe in one of the laws of physics in that for every action there is an equal and opposite reaction. I believe that you can push the body so far with medications (especially a powerful steroid with a plethora of actions) before noticing serious side effects. One possible scenario is the long term risk for cancer for those tissues that actively respond to sex-hormones, e.g., breast and prostate. If you have prostate cancer DHEA could prove deadly.
Of related interest, rom a recent interview in the London Observer of Drs. Malcom Carruthers and Steven Shalet:
“Testosterone controls virility. Low testosterone equals low libido, reduced sexual performance, lack of vigor and energy, and in extreme cases, osteroporosis and bone problems …
“… in light of this, men can blame their urgent need to disappear off to the pub, snooker hall, golf course or rugby international on their hormones, and anyone unhappy with that will be powerless to protest.”
Unfortunately my wife is never convinced about my scientific explanations for playing golf.
The mites live on sebum, the oily material that the scalp secretes. The mites are universally present in all humans after adolescence suggesting that alopecia may depend, among other things, on the genetic suceptibility of the subject. The following news release relating alopecia to mites was provided to the UPI during a Dermatology conference in Miami, 1998.
Here's the Official Alopeciac Mite Song:
“I love my jeans, and the way they hug, but my genes, my genes, my genes got bugs, There's vermin on my chromosomes, and that's why I'm a chromo-dome, OOOH, mites! Get away from me! OOOH mites, Let my lashes be! They are here to stay and my new shampoo washes them away, but they come back too, and they make me sneeze and they make me wheeze, and they make me do the wig strip-tease, I'm humbled by their strength and power they chew on my hair and oil every day and hour. I love my genes, and my grandma's, too, and I want to know - Grandma? Grandma? OOOH, why didn't mites do this to you? Can my neighbor get 'em if I use her pool? OOOH mites, mites in my genes.”
However, other dermatologists took his idea and showed by statisitics that dental decay in the general population was just as common as in people with AA (bear in mind that tooth decay was much more common at this time).
Hair, nails, teeth and eyes are all related "organs" although their similarity of structure and cell type is much more obvious in less complex animals than ourselves. Although the link between hair and nails being affected is clear, there has been no evidence to suggest that eyes or teeth are affected in AA any more than in the general population. Most likley for mammals (dogs, horses, mice, rats, primates and cattle can get AA too) teeth and eyes are so differentiated from the hair follicles that they escape the attention of the immune system attacking hair follicle antigens - assuming this is an immune based condition.
| normal | ======================================== |
|---|---|
| dysthimic | ================================ |
| major depressive | ======================== |
People with dysthimia are not very happy and kind of blue. Most may not even know that there is anything wrong. They never know exactly what is wrong with them, but always feel different from everyone else. They don't feel the same joy in life as other people seem to be getting out of it. Never feel like they are good enough, don't want to be in public or with other people. They sleep alot and just never have any energy, any positive thoughts about their future, and always see the glass "half empty" as they say. They may have a problem with anxiety also and it makes it alot worse. The only way to explain the feeling is like walking around in a fog all the time. One of the participants within our discussion group didn't realize what was her problem until she was 26 years of age. After being put on medication for the first time, she first experienced what it was like to feel "normal" and what life felt like. It was an amazing transformation for her.
You may many things on-line about it, on-line groups such as our alopecia list server that you can join. You just have to do a little searching. List server are like friends that may help you know when you are kicking yourself around.
The hardest part for some persons looking for help has been the fact that other people don't understand what is happening. Most people think that you can just "snap out of it" NOT TRUE!!!!!!!
Artifical fiber implants into the scalp were popular in Japan a few years ago until these problems were recognized. The Japanese manufacturers of the synthetic fiber then claimed that they had solved the problem of inflammation by coating the synthetic fibers with a special polymer. However I doubt that this would truely resolve the inflammation problem and it does nothing to block skin infection via the punched holes in the scalp.
The following may be of interest:
New Jersey Files Suit Against United Micro Systems
In response to a lawsuit filed by the New Jersey Attorney General and Division of Consumer Affairs Director, a New Jersey Superior Court judge has frozen the assets of United Micro Systems ("UMS") of Voorhees, New Jersey.
UMS offers a hair replacement system called "Dermal Retention," about which the state alleges UMS made false and misleading claims in both its internet advertisements and in national magazines.
The suit names both former and current owners and employees as defendants. Camden County Superior Court Judge Theodore Z. Davis has ordered the defendants to appear for another hearing on May 18 to respond to the states allegations.
According to the Attorney General, UMS and the defendants "...lured men and women into purchasing their product with unsubstantiated claims about this so called 'hair replacement system' and then turned their backs on the victims when the product failed... We cannot and will not stand by while salespeople allegedly take advantage of trusting consumers. That is why we're taking action in this matter."
Complaints in the case by consumers range include high cost (as high as $8,000), misleading the public by calling the hair replacement "permanent", and that the hair systems did not look natural and came loose within days.
Several UMS employees are also former employees of another New Jersey company called International Cosmetics Laboratories, Inc ("ICL"), which marked a fradulent treatment for baldness called the "cosmetic suture process." ICL was prosecuted by New Jersey Consumer Affairs in 1994 and eventually went bankrupt.
The formal charges against UMS by the state include:
Falsely claiming that Dermal Retention was permanent and that it created "an individual hair effect"; UMS promised that the hair replacement process would look natural and create an undetectable hairline; Misleading before and after photographs were used in its promotional materials. UMS promised consumers that their product was warranteed and had a satisfaction guarantee which were not honored.
Eat a low-protein, high-carbohydrate diet. Eliminate milk and milk products, including commercial foods made with milk. Minimize consumption of foods of animal origin. Avoid polyunsaturated vegetable oils of all kinds. Most importantly, supplement the diet with a program of regular aerobic exercise. For more information on diet and other health concern issues you may visit his site at http://www.drweil.com.
Echinacea is not recommended for people with autoimmune disorders because it boosts production of interferon-gamma (IFN-g) which is a cytokine (chemical messenger) for the immune system. IFN-g is involved in Th-1 responses, which stands for T-lymphocyte helper cells. Th-1 responses are pro-inflammatory/"attack". Conversely, Th-2 responses (still T-helper cells) are "anti-inflammatory" and order the Th-1 cells to "stop attacking". The same thing holds for melatonin. (See Melatonin)
“I was born with total alopecia, and my daughter was born with partial alopecia. Aside from alopecia we both have some dental abnormalities. Basically we are missing some teeth, and the teeth that we do have don't have the enamel coating. Both of us also have problems with our fingernails-they are rather unusual as they are thick and curve inward-like an upside down spoon. Our sweat glands and tear ducts don't work the way they should either. A person born with two of the things that I mentioned could be classified as having Ectodermal Dysplasia.”
A recent published study has isolated the gene of a condition that manifests itself with baldness. The condition is called ectodermal dysplasia- a condition described by the English naturalist Darwin over 100 years ago. The disorders arise from disturbances in one or more ectodermal structures and their accessory appendages. The absence of, or deficient function of, at least two derivatives of the ectoderm constitutes a form of ED. Each combination of defects represents another type of ED and has a specific name. At least 150 different forms of Ed have been identified. Individuals affected by ED have at least two or more of the following manifestations:
Familial studies suggested it was a disorder related to the sex (X) chromosome. Some 125,000 Americans suffer from the condition. The results of the study suggest that scientist may develop a screening test to detect women who carry the gene or affected fetuses dring pregnancy- other practical applications (especially as it may relate to baldness remain obscure).
Treatment consists of avoiding excessive heating in rooms as this increases skin dryness and itching. Woollen and nylon clothing can (if next to the skin) cause irritation and should be avoided. Clothing made from 100% cotton is ideal. Biological (enzyme) washing powders may aggravate eczema and so should be substituted with non-biological detergents. It should be noted that tiredness and emotional stress do aggravate eczema. Foods implicated in allergic reactions include dairy products, wheat, seafood and peanuts. Dietary exclusion should only be carried out under the supervision of a dietician as this could lead to malnutrition.
Interestingly, there is an increased density of house dust mite allergen (Der p1) in the homes of people with atopic eczema. Does increased exposure to house dust mites cause the eczema or is the increased density secondary to the heavy shedding of skin scales on which the mites feed?
The hypothesis that AE improves if amounts of house dust mite allergen in the home are reduced was the subject of a double-blind controlled trial, the results of which were published in the Lancet (Tan,B.B et al, 1996). Active treatment comprised of Gortex bedcovers, impenetrable to the house dust mite (placebo - cotton covers), benzyl tannate spray, a mite killing agent (placebo - water) and a high-filtration vacuum cleaner (placebo- conventional domestic vacuum cleaner).
Although the severity of eczema decreased in both groups, the active group showed significantly greater improvements and it was concluded that the activity of AE can be greatly reduced by effective house dust mite avoidance.
Estrogen is an indirect antiandrogen - it leads to reduced levels of testosterone. Several studies with topical application of estradiol (estrogen) on men with androgenetic alopecia suggest growth promotion of hair, and/or stabilization of hair loss. The particular study I am thinking of is German:
Orfanos CE, Vogels L. Lokaltherapie der alopecia androgenetica mit 17(alpha) ostradiol. Dermatologica 1980; 161: 124-132.
However, the side effects with estrogen could be significant - for men at least - including decreased libido and, um, growth of breasts plus increased cancer risk.
Looking at AA the story gets more complex as estrogen also has a role to play in the immune system. CD8 T cells (which are destructive cells found in large numbers in/around AA affected hair follicles) have estrogen receptors and are stimulated into action by higher levels of the hormone. Estrogen also promotes proliferation of B cells and production of immunoglobulin. That might suggest estrogen blockers could be of some use in AA assuming these cell types are causing hair loss in AA. However, IMHO estrogen levels are not of fundamental importance in AA (that does not exclude a role for them though) plus, given the side effects of estrogen blockers, their future does not look too bright. Abnormalities in estrogen metabolism, have been reported in other autoimmune disorders, including lupus, rheumathoid arthritis and multiple sclerosis.
Eucaderm Ltd 7 West Terrace Eastbourne, East Sussex BN214QX England TEL +044 1323645164 e-mail hair@mistral.co.uk
It is apprently great if you have psoriasis or eczema but of all of the list server members that have reported using the product for alopecia, none have reported positive results.
“Finally, an update on the eucalyptus oil. The oil did indeed help to soothe the stinging and itching of my scalp, but as much as my husband and I both find it to have a pleasant aroma, it was much too overpowering to use in oil form. I have switched to Dr. Bronner's eucalytus soap in diluted form and am using it for shampoo. The shampoo controls the itch quite nicely. The stinging sensation had actually stopped after I first tried the oil and much to my surprise I find that I now have some pigmented hair growing in the areas that were stinging so much.”
Eucalyptus oil (liquid or in a bar) is readily available in health food stores. Very reasonably priced too; affordable for any pocket book. It is used because fleas and ticks are repelled by eucalyptus. (See Journal of Allergies and Clinical Immunology, Oct., 1997) (See Demodex follicularum).
Kiehl's is now making an Eucalyptus Liquid Body Cleanser. As with all Kiehl's products, it's probably not cheap but good quality. You can call Kiehl's at 1-800-KIEHLS-1 for the store closest to you, or a catalogue. It contains the fragrance but not much of the oil per se. Eucalyptus oil is used topicaly never internally.
The irregular construction of the hair gives it weak spots where it can readily break off. This gives rise to the stumpy hair fibers called exclamation mark hairs that can often be seen in expanding patches of AA. This increasing irregularity of the hair fiber reflects the increasing influence of the inflammatory infiltrate through time. Eventually the inflammation builds up to such an intensity that the hair follicle finds it impossible to make any real hair fiber. Breakage usually occurs some 3 to 4 mm from the scalp. Often the broader distal edge tends to be normally pigmented while the proximal edge (adjacent to the scalp) appears paler. Exclamation hairs are not diagnostic for alopecia areata and may be seen in several different conditions including chemotherapy.
These rights include but are not limited to the subject's right to:
“My hair is just about totally gone, and I have muscle spasms, I can't sleep properly, e.g.; fall asleep about 2-3:00 A.M. and up at 6:00 A.M. for work, this is daily. I am tired all the time, I am very depressed, yet I seem to be moving to fast.”
Fibromylagia referes to chronic and widespread musculoskeletal pain. It is associated with disturbed sleep, anxiety, depression, chronic fatigue syndrome, irritable bowel... (does the list sound familiar or do I need to keep on going?). To top it all, fibromyalgia has been know to antecede hypothyroidism. (See fibromyalgia under Section 6 Other Problems).
Finasteride was previously used for prostate conditions at a 5 mg dosage. I haven't read any resuls from long term studies with the drug, the package insert only details results at 24 months follow-up (17% of treated patients had hair loss versus 72% of those in the placebo group). The experimental design for the Finasteride trial differes markedly from that of the monixidil trial making comparison difficult. Thus far there aren't any indications for its use in alopecia areata/universalis.
You can also obtain your recommended supplementation of omega 3-fatty acids from the flax seeds themselves. Buy whole flax seeds and keep them refrigerated. Take enough for one week supply, grind them in a coffee grinder or blender, and take two spoons daily.
Omega 3 fatty acids (see dictionary for a definition) are not used as energy by the body as are most oils nor are they stored very much in fat cells. Rather they are used as building blocks for many critical tissues in the body, particularly membranes of the intestinal tract, brain and cardiovascular system. Lack of omega 3 fatty acids causes the body to have to use inferior substances with imperfect molecular structures in an attempt to fill this need and it is little wonder that all sorts of problems can be traced to this.
An article in Science (279:720-724, 1998) created some controversy by using an erroneous nomenclature and publicizing having found a gene for alopecia universalis. Although the patients in the article do have universal alopecia, that is hair loss all over their bodies, they do not have "alopecia universalis", a well defined autoimmune condition. The individuals in the article were born without eyebrows or eyelashes. They never experienced any hair regrowth and there was no hair follicle inflammation.
The condition the affected individuals have should have been designated as congenital atrichia. This is a very rare genetic condition that results in abnormal development of hair follicles. It does not involve inflammation of hair follicles as alopecia areata/totalis/unviersalis does. It is probably similar to a condition in mice that have a mutated gene called "hairless". This is not an accepted animal model for alopecia areata or universalis.
Although the genetic research is important in our understanding of how hair follicles are made and grow, it does not have a direct bearing on the inflammatory form of alopecia areata/totalis/universalis.
Shortly after publicizing her findings, a new web site was created. The site belongs to the Hair Research and Treatment Center directed by the Department of Dermatology of the College of Physicians and Surgeons at Columbia University. The whole purpose of the site appears directed towards attracting patients to their clinics. No new service is provided, rather, the Hair Research & Treatment Center offers patients a so-called comprehensive evaluation, including: physical examination, history, laboratory tests (as needed), scalp biopsy (as needed,) and microscopic evaluation of hair (as needed). These same services can be offered practically anywhere else in this country. The center also provides those interested an opportunity to participate in their clinical trials, many of which are sponsored by pharmaceutical companies. I can probably translate this best by saying that if they don't take the money directly from your pocket, they will charge the pharmaceuticals for the same. What bothered me most, besides their salient pecuniary interest, is the fact that part of their sales pitch goes as follows, "Patients of the Hair Research & Treatment Center will also benefit from the recent exciting discovery by Angela Christiano, Ph.D. and her research team in the Department of Dermatology- the first human gene associated with hair loss!" What they fail to mention is how is the discovery directly applied to the treatment of patients coming to their clinics? What is the so-called "benefit?" The short answer is that it can't be applied to patients. Again, this follows the trend of certain researchers in providing misleading information to patients and using inapropriate nomeclature to either promote or publicize their findings.
“He that increaseth knowledge increaseth sorrow.” —Old Testament
The following details some highlights of the article:
Case Description, Patient 1. A 12-month-old white female infant in California began to lose scalp hair 10 days after her second immunization with hepatitis B vaccine (HBV). During the next 3-months she progresses to complete baldness, but regrowth was complete by 18-months. Approx. one week after her third dose of HBV, given with oral polio vaccine (OPV) at the age of 18-months, her parents noticed recurrent hair loss, which again progressed to near total hairloss and which regrew beginning at the age of 2 yrs. Extensive medical evaluation failed to identify a cause. Her physicians considered, but discounted, the possibility that recent vaccination might have contributed since she had experienced no adverse event after her first dose of HBV at the age of 10-months, and there was NO suggestion in the medical literature or product package labeling that hair loss might follow vaccination.
(Note: the JAMA article does not identify the child (pt 1), but I'd bank on it that it was little McKenna White. She and her family were featured in an article that ran in the San Francisco Chronicle, April 21, 1994. According to that article, a nurse for the attending physician, called Smith Kline Beecham, the manufacturer of the hepatitis B vaccine (Merck & Co. is the other one) and she was told that other cases of alopecia associated with the vaccine had been reported. After learning that, they contacted the Centers for Disease Control and Prevention and were told nine cases of alopecia associated with vaccinations had been confirmed by a computerized reporting system. In contrast, however, to the JAMA statement above, in the newspaper article McKenna White's pediatrician DID think her hair loss was caused by the vaccine.)
Here was the breakdown for the 60 cases in the article (remember the problems above):
What else was wrong with this study and/or why is it ongoing? Out of 52 states, only 20 had reported any adverse events relating to alopecia. California alone reported 20 adverse events out of a total of the 56 reports that came in. Why were so many reports coming from that one state? Because the initial publicity surrounding onset for alopecia and vaccines began in San Francisco. In that one area, following the McKenna White newspaper article, 5 more cases were reported.
Before I get off my soapbox, I'd like to make a recommendation to our members here who suspect onset with vaccines. Pick up the phone NOW and call the Food and Drug Administration (FDA) at 1-800-FDA-1088 where you can speak to a real live human and request a MedWatch form be mailed to you which you will complete yourself (keep a photocopy). Or, you may also call the FDA Vaccine Adverse Events Reporting System line directly (1-800-822-7967) and leave your name, address and phone number for a form to be mailed to you. Both numbers accomplish the same thing; the second phone number is completely automated. Don't wait for yours or your child's doctor to report it; they may think (just like the alopecia "experts" at the conference) there's no conclusive evidence to support what you are thinking. WRONG.
If your child is using steroids for alopecia, you may want to DISCUSS THOROUGHLY with your health care provider the possibility of delaying vaccines.
The Merck Manual reads, “Children receiving immunosuppressive agents (CORTICOSTEROIDS, antimetabolites, alkylating compounds, radiation) may have aberrant responses to active immunization procedures. Immunizations for patients on short-term therapy should be deferred until treatment is discontinued. Children on long-term therapy should NOT be given live vaccines but may receive inactivated vaccines such as DTP; > 3-mo AFTER therapy is discontinued, they should be given an additional dose of inactivated vaccine, and then live vaccines may be started.”
Hair-raising tale of a naked ape
Jambo, a teenage chimpanzee in England's Twycross Zoo, was suffering. His skin itched, his hair fell out, he lost weight, and he seemed listless. Director Molly Badham called in Jean Brown, a farmwife who deals in natural medicines, for help. Mrs. Brown put Jambo on an acid-free diet -- heavy on cereal, yogurt, brown bread, and apricot jam -- and concocted a cream from goat's milk and oils of wild rosemary, parsley, and marjoram. Now his health has returned. So has his hair. And Dr. Brown is trying her diet and salve on humans; her husband is growing hair on a bald spot he's had for the past 45 years.
'I'm not interested in why it works,' she says. 'It works, that's all I care about." She plans to market the product.
Zoo vets believe that Jambo's ailments stemmed from an immune system problem. They are clueless about why the ointment works. 'But he's in full form now,' Badham says."
Melanie Von Zabuesnig (a previous AA patient herself now "recovered") is a herbalist whose work has been published in magazines such as Natural Health. Her email address is vz@earthlink.net her fax number is (714) 956-3115. Here's what she recommends:
Rosemary and Ylang Ylangwill stimulate the scalp, while Lavender and Atlas Cedarwood are balancing oils that help prevent further hair loss.
Massage, gently nightly massages of the scalp will relieve any tightness caused by stress. Make up a healthy Scalp Tonic and apply several drops to the affected area. Massage in such a way that you move the scalp over the bone without pulling, or moving through the hair. Continue for two minutes, on to a different area each 15 seconds.
Dissolve the essential oils in vodka, then mix together with Orange Flower or Melissa water. Use for massage as indicated.
Some of our members think that they could not use the vodka as their scalp is very dry and painful, however, the oils can be soothing.
For more information you can contact a licensed naturopathic doctor at the American Association of Naturopathic Physicians, PO Box 20386, Seattle, Wa. 98102, call them at (206)323-7610, or visit the list of CAM practitioners at alternativemedicine.com.
Also a small note on the care of nails in the book "Healing Power of Herbs" by Dr. John Heinerman states the following,
“Thick nails usually indicate poor blood circulation. For this you need horsetail (2 capsule), cayenne (2 capsules) and ginger (2 capsules).
“Lenghtwise ridges sometimes means kidney dysfunction and anemia. For this you would require horsetail (2 capsules), buchu (2 capsules), dandelion (2 capsules) and parsley (2 capsules).”
(See also pepper shampoo and aromatherapy)
I think women with hirsutism usually suffer from a greater social stigmata than those who lose their hair from alopecia areata. Remember that hirsutism causes hair growing in the face, abdomen and/or breast while simultaneously losing the one in your scalp. Two reasons would make me believe that the endocrinologist (or Gynecologist) rather than a Dermatologist is more adept at treating hirsutism. First, the most common cause of hirsutism is due to increased secretion of testosterone and androstenedione from the ovaries. Second, acromegaly (gigantism after puberty) is seen associated in 10 to 15% of cases.
2000 B.C.—Here, eat this root.
A.D. 1000:—That root is heathen. Here, say this prayer.
1850—That prayer is superstition. Here, drink this potion.
1940—That potion is snake oil. Here, swallow this pill.
1985—That pill is ineffective. Here, take this antibiotic.
2000—That antibiotic is artificial. Here, eat this root.
It may be well worth noting that transplant rejection is mediated through a special type of cell called T lymphocytes- that is, the same type of cells that have been incriminated in rejecting the hair follicle in alopecia areata. There is some work to suggest that alopecia areata is related to an increased incidence of these types of proteins (e.g., DR11). Such an association is not meant to define a cause/effect interaction but rather a thought provoking marker for disease susceptibility. Even in those cases where an association between disease and HLA have been positively identified the mechanisms underlying such a correlation remain obscure. In terms of research it is one of those pieces of data that are nice to know but nobody knows what they mean.
Q. What does HMO stand for?
A. This is actually a variation of the phrase, "Hey, Moe!" Its roots go back to a concept pioneered by Doctor Moe Howard, who discovered that a patient could be made to forget about the pain in his foot if he was poked hard enough in the eyes. Modern practice replaces the physical finger poke with hi-tech equivalents such as voice mail and referral slips, but the result remains the same.
Of related importance,
Q. Well, can I get coverage for my pre-existing conditions?
A. Certainly, as long as they don't require any treatment.
Q. What happens if I want to try alternative forms of medicine?
A. You'll need to find alternative forms of payment.
On the other hand some attempts at selling hair regrowth medication almost sound humorous, take for example a press release from Kevis of Beverly Hills. A U.S. patent recently was approved for "sperm shampoo", which is said to restore hair lost because of male pattern baldness. The company says that Sean Connery, who had lost most of his hair, has been using this natural product to grow it back. A recent America Online survey found that one out of four men would trade five years of their life for a full head of hair, the company says. But hirsuteness does not come cheap. The active ingredient is found on the tip of the human sperm and costs more than $30,000 per kilo (2.2 lbs). "Just as sperm penetrates an egg, Kevis penetrates the hair cuticle & follicle," the press realease claims.
You can test yourself INITIALLY for this condition by doing the follow: Put a thermometer by your bed, and when you wake up in the morning, put it in your armpit and keep it there for 15 minutes. Be still and quiet; motion can upset the reading. If it's 97.6 degrees or lower, it may indicate hypothyroidism. Keep a log.
A report by Puavilai S et al. Int J Derm 33(9):632-3,1994) showed no statistical significant differences in the prevalence of thyroid conditions when examining 152 patients with AA and an equal number of age-matched controls.--For some reason my experience is contrary to those of the quoted authors and I have seen many AA patients with thyroid problems.
Some of the patients tell me that they had so much dandruff that in order to make it less noticeable they picked the scabs with their fingernails. One of the patients from our list server, had his attack precipitated by removing a cyst from the scalp. The immunological priviledge site hypothesis envisions a possible hair-follicle barrier (similar to a blood-brain barrier) that could be disturbed (by trauma, infection, etc.) thus exposing an antigen to the inflammatory cells of the blood.
A virus could act two ways. First by disruping this barrier and exposing the antigen from its priviledge site. Second, by lowering the number of suppresor cells thus providing for a flare-up of the autoimmune reaction. Stress may act similarly by altering the CD4/CD8 ratio of lymphocytes. This way of thinking is interested in finding out whether the hair follicle is considered an immunological protected site (e.g., if the vessel wall of the capilaries of the papilla don't have fenestrations, tight parenchymal space overlying the capillaries preventing diffusion, unusual periadventitial cells, etc.).
Ayuv-vedic practice looks at the whole person and determines through questionnaires and exam a certain psychophysiological constitution based on physical characteristics; food, sleep and climate preferences; cognitive style, etc. There's a good book by Dr. Vinsent Lad about Ayur-vedic medicine. The idea is that illnesses develop as a result of imbalances in the constitution(s) -- you can be one, or a combo of 2 or 3 types. Through diet, daily practices (e.g., regular sleep hours) or whatever is appropriate for balancing your dosha (constitution), you become balanced. In addition to those, sometimes certain supplements and/or herbs are called for either for general health or to address a specific problem.
On a personal note, Dr. Chopra is extremely wealthy, a fact that is due to revenues from his books but also from his large and ever growing number of patients (followers). He has sold the idea of "rejuvenation" through herbal oil, heat therapies and "purification" treatments. I consider that his fees are somewhat outrageous (several thousand dollars) for a week's treatment and he even charges for mail consultation. I developed a personal interest in this type of alternative medicine and must say that my daughter is receiving treatment from a more traditional ayurvedic practitioner in India (for free). Right now, after about a year of treatment, I haven't found any positive effects from the therapy. I have also asked several patients that have pursued this type of alternative medicine and they have all basically told me the same thing; interesting, lots of history involved, didn't work for me, but there were no side-effects.
If you are interested in trying this alternative, there is an Indian oil readily available for this purpose. The Bringraj Oil can be ordered through Bazaar of India Imports, 1810 University Ave, Berkley, California 94703, phone: 1-800-261-7662. The price for an 8 oz. bottle (which lasts a long time) is under $20.00. It is applied to the scalp 4-5 times a week at bedtime and washed out in the morning. The Bringraj oil does not irritate the scalp. Its ingredients are listed as: Natural Sesame seed oil, Ayuverdic Eclipta alba, Sida cordifolia, Withania somnifera, Natural fragrance.
My only personal positive experience regarding traditional Indian cures relates to shampoos. Both my daughter and wife have a very senstive skin. Normal shampoos irritated the skin of the scalp unprotected by hair eventually causing a lot of itching. I discovered a herbal powder in an Indian/Pakistani store that does an excellent job without causing irritation. It is a mixture of soapnuts (aritha), acacia concinna (shikakai), emblica (amla), eclipta (bhangra), cyperus seariousus, turpeth root, eleusine corocana, and nardostashya. I hope that I have spelled everything correctly.
Ayurveda is different from Hindu philosophy. Most Hindu teachings emphasize relinquishment and renouncement. As applied to alopecia, this way of thinking directs you to relinquish your attachment to hair and any idea of control over it, while still valuing hair for it's beauty and purpose. You must renounce all personal claim and stake you may have to the resulting appearance or disappearance of hair. In this is freedom.
A statement that the study involves research, the reason why the person signing the informed consent will participate, description of the benefits and foreseeable risks to the patient (e.g., cancer for those taking sensitizers), a disclosure of appropriate alternative procedures or treatments, a description of the confidentiality of records, an explanation whether compensation or medical treatment is available if injury occurs and, if so, what they consist of, an explanation of where further information may be obtained about the study itself and the research subject's rights.
After the recruiting physician provides the information on the study, see if you can answer the following questions:
Be sure to clarify any doubts before consenting to participate in any clinical study.
The most effective treatment I have seen for IC is a yeast free diet (for at least 6 months) and treatment with an oral fungicide such as Diflucan.
IVIgG side effects include headache, nausea, emesis, chills, fever, abdominal pain, muscle pain and fatigue. Many of these effects appear to ber elated to the infusion rate. Risks related to transmission of infectious agents or hepatitis have been excluded by screening laboratories.
This is another story (unfortunately a long one) but when I started trying to help my daughter I came to the conclusion that any discovery should be based on the good will of other people and that a cure should be offered gratuitously. It is part of the third stage of Hindu philosophy where a person has to return to the world some of the blessings that have been bestowed upon him. The idea of using IVIgG in alopecia areata appeals to me, not only on its scientific basis, but because the availability of the product (a human compound) depends on the good will of those that are healthy (a blood donation). In a certain way, I envision this as the strong helping the weak.
In adults, iron deficiency occurs in several stages. In stage one, iron stores are reduced but there are no clinical effects. In stage two, there is a biochemical deficiency without anemia, which results in adverse consequences on aerobic work performance, immune function, and psychomotor development. The third stage is the most severe because no iron is left in the marrow and hemoglobin production falls below the reference range. Iron deficiency should be considered in the diagnosis of patients who present blood loss, anemia, symptoms such as lethargy, dizziness, and high-risk lifestyle or dietary factors.
However, I am not convinced of this idea. It assumes that the cells responding to the irritant are the same as the cells responding to the hair follicle antigens. I don't think so. I think the irritant induces inflammation from a mostly new group of cells and in doing so causes a change in the cyotkine environment of the skin. Cytokines are hormone like chemicals that are produced by inflammatory cells to communicate with each other. Some cytokines excite immune cells to attack and destroy, other cytokines tell cells to calm down and go home. I think there might be a change in the cytokine response that encoruages cells to move away from the hair follicles and into the upper skin layers and/or to leave the skin entirely. There is some research to suggest irritants cause cytokine production levels to change.
“My 13-year old has had AA since 2/99. In addition to the AA, she has some interesting skin conditions which I am wondering are somehow related to the AA. Since 10/98, she has had red bumps all over both legs, mostly on her lower legs. I just noticed today how bad this has gotten. She says the red bumps are not itchy or painful. She won't wear any shorts, because she is so self conscious. This condition first started when she had swimming in her PE class, and there was lots of chlorine in the pool. Allergic reaction to chlorine, even after 8 months has gone by??”
It sounds like your daughter has keratosis pilaris. The bumps may also be on her buttocks, back of her arms or even the back. They are associated with eczema, which is associated with AA. There is no cure but treatments include brushing the area with a lufa sponge or a Buf-Puf followed by a moisturizer, ammonium lactate, tretinoin or adapalene.
During a session the kinesiologist may have a patient lay on his back with the mid-drift exposed. The practitioner then helds various substances close to the patient's belly button (where a lot of his energy pathways congregate) while holding up his arm and trying to push against the kinesiologist's hand in order to detect muscle resistance. A positive test is claimed to help identify intolerances to substances as well as full blown allergies.
The men who worked on the construction of the towers for the bridge started coming down sick with unexplained ailments. Their hair was falling out; they had nausea, and at one point in time 60 men were in the infirmary diagnosed with appendicitis.
The cause was determined to be red lead paint that was used to coat the steel to protect it from the elements during its transportation from Bethlehem Steel in Pennsylvania to California. The holes for the rivets in the steel were covered with a thin membrane of the paint, and when the riveters started assembling the steel cells together the fumes from the paint caused their illnesses and hair loss.
To correct the situation, fresh air was pumped down inside the towers where the men were working and they were given filtration masks to wear. Most refused to wear the masks though.
Although the side effects of this treatment were surprisingly few (swelling, itching, etc.) I have some concerns regarding future outcome. In my own experience freeze/thawing cycles reduce the total number of generations or passages of fibroblasts in cultures. These were the cells I had isolated from skin biopsies in my AA patients. The reason I was studying fibroblasts is that they are found at the base of the hair follicle and ultrastructural studies suggest that they are abnormal in patients with alopecia areata.
Anyway, there is some evidence from the medical literature to suggest that freeze/thawing promotes an oxidative injury to cells. If this cells are already compromised by the inflammatory response at the base of the hair follicle, why injure them again?
Melanocytes are sensitive things, easy to disrupt or destroy, e.g., a little dry ice briefly applied to hair bearing skin will not do any permanent damage to the skin but the melanocytes in hair follicles are mostly destroyed resulting in poorly pigmented hair. Skin melanocytes will repopulate quickly from unaffected neighbouring areas but hair melanocytes do not recover well. Very occasionally in AA the melanocytes are not switched off and continue to produce melanin. With no hair fiber to incorporate it into, the melanin gets dumped at the bottom of the hair follicle giving the skin a bluish hue.
My southern friends always make me smile when saying "American" around me (A-MERKIN is the Texas and Georgia pronuciation). For word lovers, merkin is also the mop used for swabbing cannons (makes you wonder, doesn't it?). Although a sporran is the term used for those furry pouches that Scottish bagpipers usually wear in front of their kilt, maybe it should also be called a merkin. Just when I had finally gotten over thinking about the fact that they don't wear "underware"! Some females may actually never want to get over this fact (do you think they like bagpipes just for the music?). Still, no, it wasn't a typo, ware means manufactured articles or products of art or crafts. So in a certain sense, I think that underware is better than underwear.
“A dirty mind is a joy forever.” —Socrates
Irritation and dryness of the scalp are 2 of the most common side effects of Rogaine. Some people say it is due to the alcohol (ethanol) content of the medication (78%). Some patients have told me that washing their hair and leaving it slightly wet (to dry naturally) before aplying the medication may alleviate the dryness. Applying an emollient may be another good idea, as it should not interfere with the absorption of minoxidil. Sometimes corticosteroids in an oily media may have beneficial effects. They act as an emollient and also as an anti-inflammatory agent. Skin biopsies in some cases of androgenetic alopecia have shown an occasional mild inflammatory reaction. This has given rise to a few trials using Rogaine in combination with corticosteroids.
Several stories from our partcipants bear repeating.
“I have been using Rogaine as recommended by my dermatologist for a little over a month now. At first, my scalp was very tender, but that seems to have gone away. I don't see any regrowth yet, but I suppose it's too soon. The problem is...today I noticed for the first time that I've developed dandruff! I know that, in the big scheme of things, this isn't very important, but it's annoying and a little embarrassing. I've never had dandruff before and think it may be due to the drying effects of the high alcohol content in the Rogaine.”
“Yesterday was my 24th birthday, and I was celebrating with my mother and her husband. They had bought a beautiful cake and had brought it over to my house. Well, the candles were placed on it and lit. I made a wish, leaned over to blow the candles out, and MY HAIR CAUGHT ON FIRE!!! I heard a whooooshing noise and saw the flame in my peripheral vision and reflexively jerked my head back. I guess the "wind" from my sudden movement put the fire out. Of course, I immediately started wailing, "My hair! My hair!" Meanwhile, my mother was frantically saying, "Are you okay? Are you burned?" I didn't even bother answering her questions, but just kept saying, "My hair! My hair!" as I surveyed the damage.
“My mom and I went out to the garage and brushed out the charred mess. I kept seeing clumps of hair, two or three inches long, fall to the floor. My mother just kept telling me how lucky I was to not have been burned. Of course, I had no appreciation for this obvious fact, and was mourning the hair that had burned.
“After carefully checking out the damage today, I can laugh about the whole thing, because I don't think it's noticeable. The ultimate irony is that, I think the high alcohol content of the Rogaine I've been using (it's 60% alcohol) is probably what caused my hair to catch on fire so readily. So, in my case, any success I might have with Rogaine in terms of hair regrowth is most likely going to be overshadowed by this incident!
“So, I guess the moral of this story is that you should be extra careful around open flames when you've been dumping high alcohol content preparations on your hair twice a day, every day, for months!”
“The two dermatologist-recommended treatments I have tried in the past that have caused the biggest physical problems for me (short-term/long-term) were Rogaine and steroids.
“Specifically, the Rogaine caused me to have nausea, dizziness and a scalp rash where I applied it topically. The derm had me on Rogaine Extra-Strength for Men (not FDA approved for use in women and of questionable value for AA conditions, BTW). The derm claimed the Rogaine could not be causing these side effects even though Rogaine's own web site claimed otherwise. Funniest thing, minute I took myself off the Rogaine the problems stopped.”
“Our dermatologist recommended Rogaine for our son when he was three (now 10) - we used it about 6 months and had lots of regrowth, but Zach was just destined to be AT. No side effects, unless you count facial hair on a three year old.”
(Note: The box for Rogaine says not for use in children.)
“Rogaine side effects include hypotension (lowered blood pressure), dizziness, from lowered blood pressure. Rogaine was initially a blood pressure medication found out to cause men with male pattern baldness to grow hair. This was a side effect. Then it was found out to grow hair better than to treat people with high blood pressure, hence the marketing of the medication for hair growth. While it did not do that greaty of a job ffor people with high blood pressure, it can lower blood pressure in people with normal blood pressure. My son who six, was put on rogaine 5%. I only used it for a few days when we quit. I was cautioned by our derm at the time that it may cause him to become dizzy or pass out but that the instances were rare. I really don't know how he could give me these facts because the medication has never been tested or reccomended for children. If these are the side effects for adults, imagine what they could be for children, especially if you are applying it to the scalp, the most vascularized area on the body. I don't care what anyone says. Things applied to the skin are absorbed systemicaly. This I found out when given topical steroids to use and my son became very emotionaly labile, angry one minute to tears the next. This resolved when we quit using the steroids. Better healthy and happy without hair than with.”
One has to be careful, as some people confuse irritation with dryness. There have been only a few case reports of contact dermatitis, but most of the complaints have really been "contact irritation". The probable culprit for the irritation is propylene glycol. Rogaine is 20% propylene glycol. Upjohn limited the concentration to 20% because anything over 25% would cause an irritation on anybody. This compounds acts as an oily media to deliver the minoxidil (which usually constitues only 2% of the medication) to the scalp. Contrary to ethanol which evaporates quickly, propylene glycol may linger for a while or it may even build up a residue. This is why it is important to wash your hair freqently while using Rogaine.
Ethanol has a low flash point and could easily spark a fire, but I do not believe it stays behind all that long before evaporating. Propylene glycol does not have a low flash point, but as I said, it could possibly build residues in the scalp.
As of January 1998, Rogaine (minoxidil) will be available over-the-counter. According to some Dermatologists the 5% solution will grow up to 45% more hair than the 2% solution with the onset of hair regrowth ocurring at eight weeks compared to the current strength Rogaine which begins regrowth at 16 weeks. The new strength Rogaine is not recommended for women bcause it causes more facial hair Just what some people need, huh? Guess that a beard on a woman will take the focus off the lack of hair on their head!
Let me try and summarize some of what I have recently learned (in 1998):
Under the best of circumstances it is very difficult to quantitate hair. The methods are tedious, cumbersome and easily influenced by the style, length and coloring of the hair. Furthermore you have to account for a placebo effetc. Patients want to get better and under any therapy some of them are going to report some amount of improvement. This is equally the case for physicians who want to see improvement in their patients even when they are taking placebo. Many times hair counts do not correlate with clinical response to treatment.
The initial minoxidil (Rogaine) data submitted to the FDA on androgenetic alopecia is interesting. At four months minoxidil caused hair count increases in both the patient and the PLACEBO group! There was another evaluation at 12 months but by then all of the patients had been shifted to the active chemical. This means that at 12 months there was no placebo group to make a comparison or serve as a reference. The study did not offer any long term results but several other authors (Olsen et al, Koperski et al) have published their findings. The results suggest that hair regrowth peaks at 12 months and then declines. Overall the data for minoxidil in androgenetic alopecia is difficult to interpret and, if positive, only offers for some modest and temporary improvement.
The results for the use of Rogaine in alopecia areata are even less satisfactory. Most of the trials offering any improvement were done using it in combination with steroids. Thus far, the FDA has not approved the use of the compound for alopecia areata.
Minoxidil recently went over the counter and can be obtained without prescription. When generic versions were offered at Walmart's for $7 a bottle there was a need for the Rogaine people to establish a new need for their product. Out comes new and improved 5% Rogaine! Incidentally, in the history of pharmaceuticals it is very rare for a drug to go directly over the counter (no prescription)- just as Rogaine did.
As noted above some Dermatologists and the promoting pharmaceutical company claim that the new and improved 5% Rogaine grows 45% more hair than the 2% solution, with regrowth as early as two months and overall 5 times more hair regrowth than placebo. This is interesting since, as you may remember, in the previous trial with the 2% solution the placebo group actually grew hair. Thus far I haven't been able to substantitate these claims with a number of independently published studies. Those persons advocating the use of 5% Rogaine in androgentic alopecia and quoting the newly discovered beneficial effects are accepting as facts whatever the pharmaceutical industry have told them.
There is no experience with the 5% Rogaine in alopecia areata, but if we can extrapolate from the previous experience with the 2% solution, there shouldn't be any benefits. Forcing hair to regrow while on the active phase of the condition may be similar to kindling a fire. There is no assurance that the new hair will be lacking the antigen that incited the original autoimmune reaction. Also, it doesn't make that much sense to use a vasodilator (Rogaine) during the active phase of the condition. The end result of increasing blood flow may be to bring more inflammatory cells to the area and promote the autoimmune reaction rather than curtail the same.
“alopecia areata probably belongs among the manifestations of neurosis, and psychiatry occasionally can give rapid and instructive cures.”Neurosis per se is no longer an accepted term in psychiatry. Probably the terminology goes back to the same time period when the word physician was synonymous for leech.
The immune response to them appears to come in two "forms". For eczema (including *infantile* dermatitis), it looks like the first response is an allergen-specific T-lymphocyte proliferation related to the development of allergic cellular inflammation, in other words the T-cells show up because an allergic reaction to house dust mites (HDM) is happening. Some research hints to a HDM protein called "farinae" as the most positive allergen. Farinae is believed to be the mite's defense system against bacteria. A later human immune response is HDM-specific IgE antibodies.
In contrast, for bronchial asthma (BA), researchers found that IgE-mediated allergic reaction occurs first, and allergen-specific T-lymphocytes do not become significantly elevated until starting at the age of about *8 years*.
Some people have suggested that people who become hypersensitized to dust mites and have eczema, bronchial asthma or food allergies as a result, may also become hypersensitized to the hair follicle demodex mite resulting in rosacea or alopecia.
Of 202 patients with myasthenia gravis (MG), 6 (3%) developed alopecia areata. All six patients had a thymoma cerified by pathology; the frequency of alopecia areata rose to 17% of 35 MG patients with thymoma. In one patient who had no recognizable tumor in the mediastinum, an ectopic thymoma was present in the anterior neck. Kubota et al. Myasthenia gravis and alopecia areata. —Neurology 48(3):774-775, 1997.
There is a similar article by Kamada et al. Alopecia areata associated with myasthenia gravis and thymoma: a case of alopecia with marked improvement following thymectomy and high level prednisolone administration. Journal of Dermatology 24(12):769-772, 1997.
Ointment vehicles usually provide better topical penetration of incorporated drugs than do creams or lotions because of their occlusive nature. They are applied one to several times daily and increasing the number of applications will favorably impact on the rate and degree of improvement. They should be gently massaged into the skin area to the point of disappearance of the material.
I don't know how omega 3 fatty acids work to suppress an autoimmune reaction. However, several years ago I read an article by Rotondo on Faty Acid Modulation of Cell Responsiveness which was quite illuminating (J Lipid Research 34(8):291-295,1993). The article argued in favor of modulating the autoimmune resonse by
I do believe that for somebody with AA who has recovered his/her hair there may be some benefit in taking omega 3 fatty acids in order to suppress the autimmune reaction. Omega 3 fatty acids won't however act as a trigger to promote hair growth once you lost it.
Many people talk about omega 3 fatty acids as fish oil which is really not the truth. Omega 3 is manufactured in plants, including green algae. Fish eat the green algae and store in large amounts the omega 3 fatty acids which is needed for cell membrane fluidity (the water where they live is cold).That is why the North Atlantic salmon is high in omega 3 fatty acids- it eats a lot of algae on its way north. Farm fish do not have the omega 3 fatty acids because they are not fed correctly. Similarly the fish in your supermarket store has minimal amounts of omega 3 fatty acids because, a) it has been farm raised, 2) it has been cut to ribbons and exposed to the air enabling the fatty acids to oxidize. That is why I go to the fish market to buy fish and not to Kroegers or Food Lion. Just remember, if its in slabs it should be fresh and look pink, any darkish discoloration means oxidation. Salmon, sardines, herring and mackerel are among the fish with highest levels of omega 3-fatty acids. If fish isn't in your diet you can obtain omega 3-fatty acids from flax seed oil (see dictionary), evening primrose oil, or balck currant oil. If given the choice I would select black curant oil or borage oil over evening primrose oil because of their higher concentration of GLA (gamma-linolenic acid, an anti-inflammatory essential fatty acid used in the treatment of rheumathoid arthritis and multiple sclerosis). Stay away from taking fish oil capsules as they may be contaminated with toxins and don't provide the same benefits as eating the right kind of fish. Borage seed has the most GLA in it, next is black currant. Generally speaking it takes about 6 same-size evening primrose oil caps to equal one borage seed oil cap, in terms of getting the same amount of GLA.
Omega-3 EFAs are:
Flaxseed oil has ALA in it. ALA is *not* an active omega-3, but the body should convert some of it to EPA, and some of the EPA should be converted to DHA. ALA is lower down the chain, and DHA is the top of the chain. You can obtain these products at your local natural health food sore, from Vitacost (formerly The Vitamin Connection) at 1-800-793-2601, or via the net at http://www.vitacost.com/.
As I have stated in other portions of this FAQs, with my own daughter, I have avoided "invasive" therapies and have concentrated on desensitizing her for her allergies and providing a healthy dose of antioxidants (plus omega 3 fatty acids). The fact about omega 3 is just plain being healthy. The World Food Organization (yes there is such an organization) recommends at least 3 fish meal per week. The same can't be fried as once you go over 200 degrees the fatty acids are destroyed. If you don't like fish, you can obtain a healthy supply from linseed oil in your health and nutrition store. Primrose oil is also a good source of omega 3 fatty acids, but more so of omega 6 fatty acids which is not as good.
I could possibly bet that in a country such as India, that rely on a vegetarian diet, alopecia areata may not be as frequent or severe as in industrialized nations such as the United States. Plants provide for the omega 3 fatty acids and also antioxidants, as for example beta carotenne.
So far (always looking) the best borage seed oil softgels I've found are made by Source Naturals. One of them is called SuperGLA, 500-mg capsule, and has 90-mg of GLA, 200-mg linoleic acid, + vit-E and in a sunflower seed oil base. If any parent reading this is wondering how to get a softgel down the throat of a young child, my best advice is DON'T TRY IT. Cut the capsule open, mix it immediately with some food (like *natural* peanut butter or yogurt or mashed banana or taters or whatever), feed the child, and whammo you've done the impossible !!!!
My own particular opinion is that hair loss due to contraceptive usage is somewhat similar to the phenomenon described as telogen effluvium. The term referes to changes in the hair cycle of an individual. In the normal hair cycle the large majority of follicles are in a stage of growth, only a minority enter a resting stage called telogen. The use of exogenous estrogens may help to synchronize the hair cycle in such a way that a larger than normal portion of hairs enter the telogen phase. The end result is thinning of hair.
Oral contraceptives have an antiandrogenic effect. They apparently do so through several different mechanisms the best known of which is by acting on the brain to suppress the action of gonadotropins. Some contraceptives are better than others at reducing the levels of androgens. Chemical compounds known as progestins and given in different proportions with estrogens in contraceptives, have androgenic properties. Anyway, I believe that the fact that estrogens synchronize the hair cycle may be a more important/pertinent factor in hair loss than their antiandrogenetic or androgenetic properties.
Based on new clinical observations, Douglas Schar, DipPhyt, MCPP, a London- based herbalist specializing in disease-preventing herbal medicines, found that Oregon grape root may be a safe, effective treatment for chronic skin problems.
Schar prescribed the herb to 300 people with blepharitis. After three months, 95 % said that their symptoms improved significantly. He is now monitoring 1,000 people who are still doing well.
No double-blind studies exist to prove that Oregon grape helps skin problems or why, but Schar has a theory: "The herb contains berberine, which we know constricts capillaries. In inflammatory skin conditions, capillaries dilate and fluids seep into surrounding tissues. Oregon grape seems to reduce the tendency toward inflammation," he says.
The key to success is long-term use. You have to wait two to three months to see improvements," Schar says, "and you should plan to take the herb for up to a year for more lasting results.
Dosage: Oregon grape root can be taken two ways: As a tincture: 1 1/2 tsp. twice a day or as a tea: Drink 1/2 c. twice a day (Prepare the tea by boiling 3/5 g (2 tsps) of Oregon grape root bark in 4 ounces of water for 5 minutes. Strain and sip).
Systemically the enzyme needed to produce the male hormone dihydrotestosterone which promotes prostate growth. At least initially the drug is being sold by prescription. Women are cautioned because of birth defect risks. Propecia can cause birth defects -- "unrecognizable genitalia" for male babies. These women are even cautioned against touching (literally) broken tablets!!! Side effects in men include decreased sexual desire, partial impotence and other reductions in sexual performance. The problems seem to disappear after the medication is discontinued. As with Rogain the indication appears to be male pattern alopecia, not alopecia areata. The pharmaceutical trial submitted to the FDA showed efficacy for hair regrowth in the vertex and anterior mid-scalp areas but no bitemporal efficacy has been established. This means that the drug won't help those people with a receding hairline. For those that work, I presume, that the drug won't provide a cure for the condition but rather temporary regrowth.
In case you're going ahead and thinking about trying it anyway, why not try saw palmetto instead (obtained at natural health food stores). It's certainly less expensive, does the same thing Proscar does for an enlarged prostate gland, and is believed to work exactly like the drug by inhibiting 5-a-R.
I would avoid pulse steroids under the following conditions; diabetes, history of tuberculosis, adverse prior reaction to steroids, kids under 12 years of age, glaucoma that is porrly controlled, tachycardia, heart disease, and any history or disease that can be exacerbated by steroids or where steroids are contraindicated.
Found this in PubMed: Proanthocyanidins from grape seeds promote proliferation of mouse hair follicle cells in vitro and convert hair cycle in vivo. Takahashi T, Kamiya T, Yokoo Y Tsukuba Research Laboratories, Kyowa Hakko Kogyo Co., Ibaraki, Japan. Acta Derm Venereol 1998 Nov;78(6):428-32
For the purpose of discovering natural products which possess hair growing activity, we examined about 1000 kinds of plant extracts concerning growth-promoting activity with respect to hair follicle cells. After an extensive search, we discovered that proanthocyanidins extracted from grape seeds promote proliferation of hair follicle cells isolated from mice by about 230% relative to controls (100%); and that proanthocyanidins possess remarkable hair-cycle-converting activity from the telogen phase to the anagen phase in C3H mice in vivo test systems. The profile of the active fraction of the proanthocyanidins was elucidated by thiolytic degradation and tannase hydrolysis. We found that the constitutive monomers were epicatechin and catechin; and that the degree of polymerization was 3.5. We demonstrated the possibility of using the proanthocyanidins extracted from grape seeds as agents inducing hair growth.
The therapy deals a lot with identifying irrational thoughts and replacing them with rational ones. Examples:
By identifying self-defeating thoughts (which I call a run-away horse) and replacing them with forward thinking (pulling the reins on that run-away horse and gently steering it in the right direction) we feel more in control of ourselves and better able to deal with life's circumstances. We all know we can't always control what happens to us. What we do have ultimate control over is how we choose to experience things.
Here are some recipes. …
After washing the hair in this solution, rinse well, with a little borax in the last water. this wash is particularly good for oily hair.
Infuse in vinegar: rosemary, sage, southernwood. Allow to stand in bottle in a sunny window for 7 or 8 days before straining.
Infuse in olive oil: sage, thyme, marjoram and balm (all "live-for-ever" herbs). Prepare as for above recipe. Rub a little into scalp before shampooing.
1 tablespoon each of tea and dried sage. Put into 2lb jam jar, cover with boiling water, and simmer for 2 hours. Rub into scalp 4 or 5 times a week. Gradually greyness will disappear, and hair will become dark brown. Add 1 tablespoonful of rum, gin, or Eau-de-Cologne for longer keeping.
Most of these herbs putatively act as nerve sedatives, aid in digestion, help coughs and colds, are used for poor skin, and as a heart and kidney tonic.
A worker who was employed by a company in Lucknow, India that manufactured and maintained drums used in photocopy machines developed AA and later became AU. In his case, it was determined to be caused by exposure to a selenium alloy used for the drums, and it showed up in his blood and nails.
My own use of biopsies has been solely for research purposes. Thus far I had sixteen biopsies in my scalp and 1 in my forearm. I have had no complication in any of them. The one in my arm has taken a slightly pinkish coloration and looks like a mosquito bite.
The procedure can be described as follows:
The skin is wiped with 70% alcohol and a local anesthetic (lidocaine 0.5% or 1.0%) is injected under the skin using a 1 ml syringe with a 26- to 30-gauge needle. Patients allergic to lidocaine are given Benadryl instead. The outline of the wheal is marked with a pen. After about 30 seconds a skin punch is driven by twisting and pushing into the skin. After attaining the proper depth (the whole extent of the dermis), the punch is withdrawn. The edge of the skin plug is then be grasped with a forceps and pulled outwards. Tissue holding the base of the plug is then cut with either scissors or a scalpel.
Risks from a skin biopsy can usually be classified as those involving pain, bleeding, and/or infection. Although pain is minimal, a local anesthetic (i.e., subcutaneous lidocaine) is used to numb the biopsy site. Lidocaine (1%) is a local anesthetic which may have side effects such as urticaria, edema, lightheadedness, and dizziness. More serious adverse effects, such as hypotension, bradycardia, confusion and convulsions have been reported rarely, and are associated with other methods of administration. The minimum recommended dose for percutaneous infiltration is 1 ml according to the Physician's Desk Reference. The punch biopsy is a quick and practically painless procedure where a very small area ~3mm2X2mm deep- of skin is removed. Bleeding is minimal and easily controlled by appl0.ying a bandaid.
To limit the risk of infection, the skin is cleaned with alcohol and the biopsy is performed with sterile (disposable) instruments. There is also a risk for keloid formation and excessive bleeding. Those subjects with a positive history for either of the latter risks should be warned about possible consequences. The small wound is kept dry for 48 hours and inspected for complications by the patient every day for three days. The patient is usually instructed that the biopsy heals with a slight scar. The borders of the incision are irregular and generally slightly smaller than the size of the punch. After a few months, the initial pinkish coloration at the site of the biopsy will become skin color or lighter making it even less noticeable.
Related to this I would like to add that hair follicles react differently to hormones depending on their location in the body. For instance, the male hormone will cause scalp hair loss yet encourage facial hair to grow profusely (i.e., longer and thicker). It is also very commmon for women with female pattern alopecia to experience a slight increase in pigmented chin, abdomen and chest hair while their scalp hair thins out.
For the record, regarding squill and its metabolite (scilliroside): There are *no* blood chemistry or urine tests to identify scilliroside metabolites after exposure. There have *never* been any studies to determine DNA mutations, teratogenic (birth defects), or carcinogenic effects after exposure -- long-term or otherwise. To my mind, one or two years of applying a squill-based cream to your scalp or skin is extremely long-term exposure.
Several govt agencies in the US declared red squill a hazardous substance many years ago. One warning issued was that it should *not* come in contact with skin. Actually, it's not even used for rat poisoning in the US anymore, not since the 1980s.
You might find a little extra info at Plants for a Future.
In AU the "stork bite" (red marks on the back of your neck), also known as a nuchal nevus flammeus is present about 44% of the time. The general population has it about 20% of the time. When the nuchal nevus flammeus is present there is often a higher incidence AT/AU but some physicians feel that this association may be spurious.
Some side effects of synthroid include a partial hair loss that may occur rarely during the first few months of therapy, but it is usually temporary. Synthroid has also been implicated in causing osteoporosis. If you have been taking Synthroid chronically, consider request a bone density measurement test to establish a baseline now. Dual Energy X-ray Absorptiometry (DEXA) is one way to measure bone mineral density, and it's suppose to be safe. DEXA uses less radiation and is much less expensive than CT scans, so hopefully your friend's doc will see the rationale in agreeing to it and/or automatically recommend it.
Also, below is a snippet from another List member's post:
“Went for all types of blood tests and found that I have Hashimoto's thyroid disease and a multinodular goiter...I was put on Synthroid (T4) but still experienced severe hair loss. Doctor then found that T4 would not convert to T3 so he switched me to Armour Thyroid (T4 & T3). I have been on Armour since January and hair finally stopped falling out in April. Anyone who suspects hair loss due to thyroid please make sure your doctor checks ALL thyroid hormones including the Free T3.”
See also antinuclear antibodies (ANA).
There are several preclinical studies claiming that tacrolimus is more potent than cyclosporin, it is also not irritating, sensitizing, and has a very low systemic absorption (when applied topically). This includes trials of patients using it on the face where it would provide a major advantage over other therapeutic modalities such as corticosteroids. Most of the trial that I know haven't followed patients for a very long period of time (lets say 10 years). I am sure that someone will be looking at long term side effects as dermatitis tends to be a chronic condition that requires multiple and continous treatment. It appears, at least on paper, that Tacrolimus holds a good promise for symptomatic treatment although it would fall quite short of being a cure.
Animal studies showed hair regrowth in animal models of AA. Some human studies have not been properly controlled studies nor have they been extensive. They were pilot studies. No published human studies showed benefit from any topical use other than one study that showed regrowth when oral Tacrolimus (FK506) was combined with oral steroids. Other human and animal studies of oral FK506 showed no benefit. When one of the patients in a clinical trial for alopecia asked his Dermatologist about the success rate of the medication, the physician answered that BOTH of his patients had been unsuccessfull!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! If you tape the !!!!! marks to your forehead it would probably provide a better esthetical result (resembling hair) than using this drug. Again, I emphasize that the drug's only promise is for temporary regrowth, not as a cure for the condition.
It is interesting to note that when rats or mice shed (our typical animal models for study) they do it more or less all at once, but in a "wave". Head to toe, so to speak. So, basically *all* of their hair is in one stage at any given moment. Also unlike humans, their hair doesn't automatically fall out after telogen. It takes new hair (fur) growing in to push the old hairs out. Typically for humans, about 10% of our scalp hair is in telogen at the same time, but not in one distinct area - rather evenly over the entire head.
Ref. Prasad AS, Meftah S, Abdallah J, et al. (1988) Serum thymulin in human zinc deficiency. J Clin Invest 82(4):1202-1210.
I found it interesting that at the bottom of their web page, in the smallest print imaginable (I had a LOT of trouble reading it and I have a *big* monitor) it reads: “Nothing presented here shall be construed as a claim or representation that ThymuSkin Cosmetics … are intended for the diagnosis, treatment, cure, or mitigation of any disease.”
They're sort of talking out of "both sides of their mouth" at the same time, if you catch my meaning. Saying it will work, it's proven to work, but we won't guarantee it. And, if you try it and it doesn't work, it's your loss not ours.
I ask myself, if something (ThymuSkin) has such a proven track record of success (67% men/94% women) then why not offer a refund to the small percentage for whom it won't work. Sounds like a good business practice to me, if it was truly so successful, as *they* present it to be.
The usual panel of tests include total and free T4, T3, and thyroid-stimulating hormone (TSH).
The fungus invades the hair shaft and causes the hairs to break. Inflammation and scaling may be present. Treatment requires application of topical anti-fungal creams, washing of the hair with Nizoral shampoo, as well as oral anti-fungal medication (Griseofulvin), usually for a period of 2 months.
The infection may be transmitted through combs, brushes, barrettes, pomades, bed linen, stuffed toys and from person to person. Most children are not contagious if under treatment, and may attend school.
Trichology is the science of the hair and scalp and originated in Britain at the turn of the century as a para-medical branch of Dermatology. It provides advice and treatments for all hair and scalp types and problems, including; hair loss (all conditions), general hair care, dandruff, scalp oiliness, etc. They provide advice for lifestyle benefits to naturally help the hair or scalp without the use of prescription medication, i.e., diet, vitamins, exercise, relaxation, etc. (although they do refer patients to physicians for medication, if necessary). Trichology is an holistic science in that it recognizes that a healthy hair and scalp is dependent on the health of the body, and vice versa.
A problem with trichologists (as with other specialty disciplines) is that some are more qualified than others in the sense of keeping up with rapidly developing research, etc. Also, some specialize in cosmetic problems while others in dandruff, in counseling patients who are having a difficult time dealing with their hair loss, performing clinical trials, etc.
Some patients with trichotillomania may be misdiagnosed as alopecia areata and vice versa. The bald patches in trichotillomania may be fairly oval and the short broken hairs left after pulling resemble exclamation mark hairs. Also, George et al., in the New England Journal of Medicine found that over 50% of bulimia patients were liable to have trichotillomania and, interestingly enough, those patients were not only more reluctant to talk about their trichotillomania than their bullimia (another reason for a misdiagnosis by an inexperienced clinician).
The eventual conclusion was that Dr Joseph was actually observing hair loss as a result of the cats scratching their hair, and each others, out around the site of surgery as a result of the stress induced by the procedure. This psychological barbering is common in many species under stress. Of course without nerves to send feed back about the scratching and any damage it was doing, the cats could scratch away at this site all day without feeling any pain.
Type B personalities are more laid back. Who knows what type C personalities are? I've never known any!
The primary lesion in urticaria is a wheal that grows and coalesce with its neighbors. The wheals are a transitory phenomenon that manifest themselves in terms of minutes to hours only to change in shape or disappear altogether. Itching may be quite severe. Any urticaria that is present for less than 12 weeks is arbitrarily classified as acute while eruptions of longer duration are called chronic. In some cases urticaria is a side effect of medications, in others it may accompany a viral infection. Still, the underlying mechanism is unknown. Some cases are thought to be due to a reaction involving IgE antibodies. These are the same type of antibodies that mediate atopic reactions, e.g., allergies, dermatitis, asthma, etc. Since 40% of patients with alopecia areata suffer from an atopic condition (as compared to 20% of the general population) it seems possible that urticaria may be an occassional concurrent condition for patients with alopecia areata. Treatment is with H1-antihistamines but with continued dosages tolerance to the antihistamine will develop.
Two case histories may be illustrative:
“I have suffered from chronic "hives" since I was 22. I'm 38 now. I get them every 2 to 3 years and it takes a good 6 months to get rid of them. I became AA 4 years ago and just recently started getting hives again. I manage them with Atarax and every now and then a 6 day Medrol dose pack to kick start the system. I've also had psoraisis since I was 18. No doctor has linked my skin maladies with my hair loss as of yet.”
“Just to share my daughter's experiences...Beth has AA since 5/96, and is 12 yrs old. She has experienced hives on one occasion, a severe case requiring a trip to the emergency room (4 yrs old). We could find no apparent cause. Hers were so bad, her skin actually bruised when the welts went away.”
I understand Viviscal is not classed as a 'drug' and therefore does not require FDA approval. The product should be used for a least 6 months before assessing treatment efficacy. It is available in the US. A study with positive results was published by Lassus A, Eskelinen E J Int Med Res, 20: 6, 1992 Nov, 445-53. To my knowledge there have been no follow-up articles. Some of our members who have tried it reported that it was both very expensive and ineffective.
Some people CANNOT absorb zinc, or only absorb it poorly. A deficiency of this trace metal can be inherited as a recessive trait in acrodermatitis enteropathica. CELIAC DISEASE, Crohn's disease, sickle cell anemia, diuretics, and oral contraceptives all interfere with zinc's absorption and metabolism. In addition, women on "the pill" who who supplement their vitamins with folic acid are at a special risk for zinc depletion. Large doses of folic acid lower zinc concentrations in the blood, making them prone to a zinc deficiency. Also, calcium bicarbonate found in hard tap water interferes with zinc's absorption and utilization.
Some people have advocated zinc deficiency in the pathogenesis of alopecia areata. These people believe that zinc supplementation may be of benefit by modulating the immune system and causing an overall increase in the total number of CD8 cells (supressors) (Lutz G, Kreysel HW in Z Hautkr 65(2):132-4, 137-8, 1990). Results with zinc supplementation have been variable, at least one controlled study showed no improvement in disease severity or activity. The trials showed that results, if positive, were obtained after prolonged periods of zinc supplementation (8 months) and that discontinuation of the mineral was followed by loss of the re-aquired hair. If you decide to use zinc, supplement your copper intake. Zinc and copper interfere with each others absorption and deficiencies of either one can produce alopecia. Acute zinc toxicity can be induced by ingestion of >200 mg in a single day. Toxicity is manifested by abdominal pain, nausea, vomiting, and diarrhea. Unfortunately there isn't an accepted test that serves as a reliable indicator of zinc status. In high concentrations zinc may act as an inhibitor of dihydrotestosterone and some people advocate its use in conjunction with vitamin B6 in the treatment of androgenetic type of alopecia. If you decide on taking zinc supplementation, be sure to take it with other food but not with other multivitamins and minerals. Zinc can upset an empty stomach and other vitamin/minerals can retard its absorption.