Alopecia areata is a hair-loss condition which usually affects the scalp. It can, however, sometimes affect other areas of the body. Hair loss tends to be rather rapid and often involves one side of the head more than the other.
Alopecia areata affects both males and females. This type of hair loss is different than male-pattern baldness, an inherited condition.
What causes alopecia areata?
Current evidence suggests that alopecia areata is caused by an abnormality in the immune system. This particular abnormality leads to autoimmunity. As a result, the immune system attacks particular tissues of the body. In alopecia areata, for unknown reasons, the body's own immune system attacks the hair follicles and disrupts normal hair formation. Biopsies of affected skin show immune cells inside of the hair follicles where they are not normally present.
What causes this is unknown. Alopecia areata is sometimes associated with other autoimmune conditions such as allergic disorders, thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis. Sometimes, alopecia areata occurs within family members, suggesting a role of genes and heredity.
How is alopecia areata diagnosed?
The characteristic finding of alopecia areata is the exclamation point hair. These unusual hairs can be found in areas of hair loss. They are visible with a hand lens as short, broken off hairs that are narrower closer to the scalp (appearing like an exclamation point). A biopsy of the scalp is sometimes necessary for a diagnosis.
How is alopecia areata treated?
In approximately 50% of patients, hair will regrow within a year without any treatment. The longer the period of time of hair loss, the less likelihood that the hair will regrow. A variety of treatments can be tried. Steroid injections, creams, and shampoos (such as clobetasol or fluocinonide) for the scalp have been used for many years. Other medications include minoxidil, irritants (anthralin or topical coal tar), and topical immunotherapy (cyclosporine), each of which are sometimes used in different combinations.
A study reported in the journal Archives of Dermatology (vol. 134, 1998;1349-52) showed effectiveness of aromatherapy essential oils (cedarwood, lavender, thyme, and rosemary oils) in some patients. As with many chronic disorders for which there is no single treatment, a variety of remedies are promoted which in fact have no benefit. There is no known effective method of prevention, although the elimination of emotional stress is felt to be helpful. No drugs or hair-care products have been associated with the onset of alopecia areata. Much research remains to be completed on this complex condition.
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February 3, 2009
What Is Alopecia areata ?
What Is Acne Fulminans ?.
Acne fulminans is a rare and very severe form of acne conglobata associated with systemic symptoms. It nearly always affects males.
It is characterised by:
* Abrupt onset
* Inflammatory and ulcerated nodular acne on chest and back
* Severe acne scarring
* Fluctuating fever
* Painful joints
* Malaise (ie. the patient feels unwell)
* Loss of appetite and weight loss
* Raised white blood cell count.
Although it mostly just happens, it may be precipitated by:
* Testosterone (legally prescribed or illegally taken to enhance muscle growth)
* Isotretinoin
The syndrome SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis and Osteitis) may be a serious complication of acne fulminans.
Management.
Patients with acne fulminans should consult a dermatologist urgently. Management can prove difficult, and several medications are usually required. These may include:
* High doses of oral antibiotics such as erythromycin (2g/day)
* Anti-inflammatory medications such as salicylates (aspirin)
* Systemic oral steroids such as prednisone (20-60mg/day)
* Dapsone
* Isotretinoin
Topical acne medications are unhelpful.
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What Is Acne Cosmetica?
Acne cosmetica is a mild but persistent form of acne. As the name implies, acne cosmetica is triggered by the use of cosmetics. It can occur anywhere on the body, but is much more common on the face, neck, hairline and scalp.
What Does Acne Cosmetica Look Like?
Acne cosmetica looks like small bumps across the surface of the skin or scalp. The skin will look and feel rough. Many comedones, and possibly some small papules and pustules, will be present. There is little to no inflammation.
What Causes Acne Cosmetica?
This type of acne is caused by the use of comedogenic hair or skin care products. When a cosmetic product accumulates within the follicle, the pore becomes blocked. Excess skin oil builds up, clogging the pore and creating a blemish.
Pomades or hair oils, heavy moisturizers, eye creams, and makeup are all common causes of acne cosmetica.
* Is My Makeup Causing Pimples?
How Can Acne Cosmetica Be Treated?
Identifying the pore-clogging culprit is important. Are you breaking out on the forehead, hairline or scalp? Your hair care products may be to blame. Finding small bumps and whiteheads in the eye area or on the upper cheeks? Your eye cream could be too heavy. Bumpiness and breakouts over the entire face and neck area most likely are caused by moisturizer or foundation makeup. Once the source of the breakouts is identified and use is discontinued, acne cosmetica gradually improves.
Sometimes it's not practical to stop using your hair or skin care products. You can still reduce the amount of pore blockages produced by only choosing products labeled "noncomedogenic". Switch to an oil-free moisturizer. Apply hair pomades and oils at least one inch back from the hairline, or only on the ends of the hair, if possible. And make sure to thoroughly cleanse all traces of makeup from your face at the end of each day.
To help clear existing breakouts more quickly, and to inhibit the formation of new comedones, use a cleanser or treatment pads containing salicylic acid. Regular exfoliation may also help to speed clearing of acne cosmetica. As with any form of acne, see your doctor if you aren't seeing improvement after six to eight weeks of treatment.
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