There are three types of alopecia: alopecia areata, alopecia totalis and alopecia universalis. Their etiology and treatment are basically the same, but the degree of clinical manifestations is different.
[ Clinical manifestations]
Alopecia areata often occurs suddenly without any warning. Patients often have no conscious symptoms and are at a loss because of their suddenness.
The first alopecia area can be born in any part of the human body, but it usually occurs in the head. On the scalp, or eyebrows, beard, etc. It is estimated that the incidence of alopecia areata in the population is less than .1%; About 95% of alopecia areata patients have lesions confined to the scalp.
Alopecia areata is often characterized by independent and localized hair shedding, round or oval, with clear edges and a diameter of 1 ~ 2 cm or more. The skin in the bald area is smooth and shiny, without obvious atrophy, but pores are still visible, which makes the hair around it difficult to fall off, and the roots of the fallen hair become thinner and the hair balls shrink, which can form an exclamation mark shape. . If the damage increases gradually and the number increases, the adjacent skin lesions can merge into patches with different sizes and irregular shapes. At the beginning of recovery, soft, yellow and white hairs can be seen on the affected part, which gradually become thick and black, and finally return to normal. The course of alopecia areata is long, most of them can recover, and a few patients can relapse after recovery.
if the disease continues to develop, the skin lesions may involve the whole head, and even all the hair will fall off. At this point, the scalp can still maintain its normal appearance, which is total baldness. In severe cases, hair falls off all over the body, including eyebrows, eyelashes, beard, armpit hair, pubic hair and body hair. This situation is called alopecia universalis. About 1% of male patients with alopecia areata may develop alopecia universalis.
clinically, alopecia areata can be divided into three stages according to the development of the disease. (1) Progressive stage: the damage scope of hair and skin is expanding day by day. On the skin with normal appearance around alopecia areata area, hair is loose and easy to catch off. (2) Static period: Generally, after 3-4 months, alopecia areata can stop developing, and it can remain unchanged for a long time, and the hair attachment around the alopecia area is quite firm. (3) Recovery period: Hair begins to grow in the alopecia area.
Some patients may have dizziness, itching, low back pain, tinnitus, dizziness and other symptoms. Doctors can find that a few early patients can see erythema and edema in the bald area, and the hair follicle mouth is clearly visible.
[ Pathological analysis]
At present, the pathogenesis of alopecia areata is not completely clear. Most people are caused by excessive mental stress and physical fatigue, but some people do not have these reasons. Medically speaking, it has a certain relationship with autoimmunity. Its etiology is unknown, but emotional depression, endocrine disorders, etc., often easily lead to this disease.
This disease may cause dysfunction of subcortical center and autonomic nerve, vasospasm of dermal papilla, and hair dystrophy, which may lead to hair loss. If you suffer from intense mental stimulation and fatigue, you may suddenly get sick or aggravate your condition. For alopecia areata with allergic background, it may be an autoimmune disease. In addition to vasculitis and perivascular inflammation in the dermis, the vascular branches of hair follicles also have vasculitis, and the blood vessels are destroyed, resulting in a decrease in vascular network and insufficient blood supply, resulting in hair loss. Immunological studies show that this alopecia areata can appear anti-thyroglobulin, anti-adrenal cells, anti-thyroid cells and other antibodies, but there is no anti-hair follicle antibody, so it is considered as an autoimmune vasculitis alopecia. At present, it is not certain that alopecia areata is an autoimmune disease, but it may be accompanied by autoimmune diseases and temporarily effective on corticosteroids, which at least suggests that autoimmune factors may be involved in some cases. In addition, endocrine disorders, focus infection, intestinal parasites, etc., may also be pathogenic factors.
[ Theory of Traditional Chinese Medicine]
The classic book of Chinese medicine "Treatise on the Pathogens of Diseases" wrote: "People have wind evil, which exists in the head. When they are weak, they will lose their hair, their muscles will die, or they will be as rich as money, or they will not be born and will not itch, so they will lick their heads for ghosts." As the ancients said, ghost licking refers to massive hair loss, and its shedding place is either the size of money or the size of finger belly, and the affected area is neither painful nor itchy. At the same time, the ancients also knew that ghosts licking their heads were not caused by ghosts, but by wind evil invading the weak human body. Once wind evil invaded the head, the lack of yang in the head would lead to hair loss.
Traditional Chinese medicine believes that this disease is often caused by young people's blood heat, followed by emotional irritability, frustration of seven emotions, stagnation of fire for a long time, intense heat, "wind-driven leaves falling", and hair loss. Therefore, teenagers suffer from this disease, mostly caused by internal heat, and its treatment should also be based on clearing heat and cooling blood, expelling wind and promoting hair growth. Never take tonics in vain. Otherwise, the more it is replenished, the hotter it is, and the more it falls. Mental and emotional changes are one of the important causes of this disease, which is consistent with Chinese and western medicine. As long as you try to keep your mood stable and get enough sleep in your daily life, you can at least prevent mental stimulation and excessive fatigue.
treatment
alopecia areata can be treated with internal medicine, external medicine and diet therapy.
[ Western medicine treatment]
The treatment should first be based on the area of baldness. If the area is small, only local medicine is used, and topical hormone medicine or fresh ginger juice is used to stimulate the growth of hair follicles. Generally, hair can grow in 3-6 months; If the area is large, you can take oral hormone, prednisone 15-3mg every day, and gradually reduce it. Generally, hair grows within 2 months, but because this drug has certain side effects, it needs to be taken under the guidance of a doctor. In addition, multivitamins and some traditional Chinese medicines, such as Shouwu tablets, also have the role of adjuvant therapy.
[ Chinese medicine treatment]
Chinese medicine has long recognized alopecia. Besides storing blood in the liver, the hair is blood, and the kidney governs the bones. The reasons for its glory are related to kidney deficiency and blood deficiency. In recent years, there is a theory of blood stasis, so the treatment of baldness is mainly to tonify kidney, nourish blood and promote blood circulation. Its branches of traditional Chinese medicine are roughly heart-qi deficiency type, liver-kidney deficiency type, liver depression and blood stasis type, and qi-blood deficiency type. Patients can be treated dialectically by doctors with nourishing blood and blood, nourishing liver and kidney, invigorating spleen and qi, nourishing cool blood, soothing the liver and regulating qi, arresting astringency and dredging collaterals.
(1) Yangxue Buxue recipe: If Shenyingyangzhendan is modified, it is composed of drugs for nourishing blood, tonifying kidney and expelling wind, such as Radix Rehmanniae, Radix Angelicae Sinensis, Fructus Ligustri Lucidi, Semen Cuscutae and Notopterygii Rhizoma. A few people who react after taking the medicine, such as throat and dry mouth, are given Liuwei Dihuang Pill or Dancao Xiegan Pill.
(2) Prescription for nourishing liver and kidney: Radix Rehmanniae Preparata, Radix Angelicae Sinensis, Morinda officinalis, Herba Cistanches, Mature Virginitis, Fructus Mori, Notopterygii Rhizoma, Radix Paeoniae Rubra, Radix Salviae Miltiorrhizae each 12g, Rhizoma Chuanxiong and Herba Schizonepetae each 1g, which is especially effective for adolescents with short course of disease and few alopecia areas.
(3) Jianpi Yiqi recipe:
(a) Yigong Powder is the main ingredient, with 3-6g of Astragalus membranaceus, 12-15g of Codonopsis pilosula, 9-12g of Atractylodes macrocephala and Poria cocos, 6g of Pericarpium Citri Tangerinae and 12g of Glycyrrhiza uralensis.
(b) 2g of Ginseng Radix Rubri, 5g of Radix Astragali, 3g of Radix Paeoniae Rubra, 45g of Atractylodis Rhizoma, 2g of Radix Glycyrrhizae Preparata, 3g of Cortex Cinnamomi, 2 pieces of Fructus Jujubae, 5g of honey bees, 1g of honey pills, each containing 3.8g of crude drugs, one pill each time
.
(5) Shugan Liqi Prescription: Prescription such as Xiaochaihu Decoction is used to treat alopecia areata, and it is also reported in Japan that Xiaochaihu Decoction is used to treat this disease, and the effect is satisfactory, especially for those alopecia areata patients related to neurological factors
(6) Prescriptions such as Guizhi, Os Draconis, Oyster, Chishao, Glycyrrhiza, Ligustrum lucidum, Eclipta, Schisandra chinensis, etc.
. Polygonum multiflorum Thunb injection or granule oral; Astragalus and angelica injection; Wushu germinal pill is taken orally; Jinsuo Gujing Pill is taken orally; Qibao Meidan, twice a day, 1 pill each time; Liuwei Dihuang Pills, twice a day, 1 pill each time; Shenqi Pill or Bazhen Pill, twice a day, 1 pill each time; God should raise Zhen Dan, 6 grams, twice a day; 15 grams of Polygonum Multiflori Radix, 15 grams of Lycium barbarum, 15 grams of Angelica sinensis and 3 grams of raw Platycladus orientalis leaves are decocted in water.
rubbing fresh ginger for external use; 1 grams of Cordyceps sinensis and 4 grams of Chinese liquor are soaked for 1 week and then applied externally; 1 grams of prepared Polygonum Multiflori Radix, 5 grams of Sichuan pepper and 25 grams of white wine are soaked and rubbed three times a day.
Slice ginger with dietotherapy, and rub the skin at the alopecia area once or twice a day for 4-5 minutes each time, so that the scalp will get hot, and use it continuously until new hair grows; Rub Chili oil on the affected area several times a day to promote hair regeneration; 15 grams of mulberry bark, decocted to remove residue, concentrated, put into a bottle, and coated with hair loss several times a day; Stir-fry black sesame seeds and grind them into powder, mix with lard, and wipe the affected area; 3 ml of 75% alcohol, soak 1 centipede, take and rub the affected area after 7 days, once every other day. Alternatively, 15g of chili powder, 1g of salicylic acid, 1.5g of Mylabris fragrans, 1ml of carbolic acid and 1ml of castor oil can be dipped in 35ml of 75% alcohol, and the affected area can be wiped after 7 days. After heating eel fish oil, apply it to the affected area twice a day for 3-5 minutes each time, and 7-1 days is a course of treatment.
[ Chinese patent medicine]
(1) Shiquan Dabu Pill, 1g each time, twice a day
(2) Yangxue germinal pill, 1g each time, twice a day
(3) Yangxue Shengfa Capsule, 4 capsules each time, twice a day
(4) Shouwu Tablet, 5 tablets each time, 3 times a day
(5) Danggui Tablet.
⑻ alopecia areata pills three times a day, 5g each time, 3g each time or 9g each time, twice a day
⑼ Qibaomei Pill, one pill each time, twice a day or three pills each time, twice a day
⑽ Thin-covered Ganoderma lucidum tablets, three times a day. 4 tablets each time; Injection, 4 ml each time, intramuscular injection once a day
[ external prescription]
The commercially available Chinese patent medicine solutions are: 1% Mylabris tincture, 2% Psoralea corylifolia tincture, 25% Zanthoxylum tincture, 11 hair regeneration essence, alopecia areata hair tonic, etc. Other prescriptions:
⑴ Garlic external rubbing: Garlic is pungent and warm, and has the functions of dispelling wind, breaking cold, calming and relieving itching. It is a sulfur-containing plant volatile oil, which has the functions of exciting the mind, stimulating blood circulation and sweating.
⑵ External application of ginger: Ginger contains "gingerol", which can excite nerves, dilate skin and mucous membrane blood vessels and improve blood circulation. Fresh ginger can be used to extract juice, and a small brush dipped in ginger juice can be used to brush the bald spot three times a day.
(3) Wash fresh Eclipta prostrata, squeeze natural juice and rub the affected area 3-5 times a day.
(4) dry the leaves of Platycladus orientalis in the shade, grind them into powder and rub them with sesame oil.
(5) Glycerol red garlic juice: fresh red garlic is peeled and mashed to get juice, and the garlic juice and glycerol are 3: 2, and then the hair loss area is rubbed externally
(6) Pinellia ternata is dipped in vinegar and rubbed externally
(7) raw Radix Aconiti powder is rubbed externally with vinegar, once a day in the morning and evening
(8) 15 grams of grapefruit seeds are rubbed externally. Five times a day
⑽ spotted hibiscus wine: 9 Mylabris, 3g of hibiscus bark, 12g of camphor and 3ml of white wine. After soaking for 2 weeks, apply 7 grams of Mylabris, 12g of Rhizoma Drynariae and Fructus Sophorae, 3g of fresh Platycladus orientalis leaves, and put the above four medicines into 75. Rub the affected area
13. Platycladus orientalis liquid wine every morning and evening: 15g of Platycladus orientalis leaves, Radix Angelicae Sinensis, Semen Cuscutae and Rhizoma Zingiberis Recens, soaked in white wine (covering the medicated surface), 3g of Fructus Psoraleae and Polygoni Multiflori Radix, 15g of Semen Cuscutae and Stemonae Radix, soaked in 4-degree white wine, and rubbed on the affected area in the morning and evening after leaving. Dip the sliced ginger into the medicinal liquid, repeatedly rub 21 flowers of
⒃, and cut the fresh ginger (Rhizoma Drynariae) into 17 pieces. Put the above two medicines in a medium bowl, soak the sorghum wine in the top, seal the bowl with paper, put it in the pot, steam it for about an hour, and rub the affected area with medicinal wine every day for 4-5 times, which can happen after the month. This medicine is poisonous and should not be taken into the mouth.
⒄ 15g of sulfur, 15g of realgar and 15g of phoenix coat, 9g of squama Manis, 3g of talcum powder and 3g of pig suet, and * * * is fine powder, and the suet and pig bile are mixed and mashed into mud, wrapped in gauze and rubbed on the affected area, 2-3 times a day for 1-2 weeks.
⒅ 12g of ginseng leaves, 12g of cacumen Platycladi leaves and 12g of cortex Dictamni Radicis. After soaking in kaoliang spirit for one week, apply it to the affected area, three times a day.
⒆ 25g of Psoralea corylifolia, 25g of Eclipta prostrata and 2ml of 75% alcohol are soaked for one week and then applied externally, several times a day.
6 grams of ginger, 15 grams of raw Pinellia ternata (ground), first rub ginger on the affected area for one minute, wait for a while, then rub it for one or two minutes, and then rub it with sesame oil mixed with fine powder of raw Pinellia ternata, which has the effect of stimulating
[ single prescription]
(1) 5 grams of Chuanxiong, 2 grams of Polygonum Multiflori Radix, and 3 grams of peach kernel, breaking and breaking.
(2) Poria cocos powder: 6 grams each time or 1 grams before going to bed twice a day, or it can be taken orally with Poria cocos decoction, with good effect.
(3) Tripterygium wilfordii and Polygonum Multiflori Radix are used as main ingredients to make mixture. Each milliliter contains 1g of tripterygium wilfordii, and the adult dose is 1ml, three times a day, and two months is a course of treatment < P > (4) Treating intractable alopecia areata with Radix Astragali: 6g of Radix Astragali is decocted in water, mixed, taken separately in the morning and evening, and taken continuously until the hair grows again, and the course of treatment is 3 months to half a year, with an effective rate of 79.3% < P > (5) parching and grinding Endothelium Corneum Gigeriae Galli, with a dose of 25. The scalp of such patients may also have no conscious symptoms, and a few patients may have itching, or scalp numbness and swelling.
Some patients also shed their eyebrows, beards, armpit hair and ear hair. In severe cases, they may shed their eyelashes, nose hair and hairs all over the body, eventually forming alopecia universalis. After a month to months of progress, the condition gradually stabilized until the growth period, gradually growing white hairs and finally forming black hair.
The course of alopecia totalis or alopecia universalis is generally longer than alopecia areata, and the recovery is slow. Some patients can not heal for many years, or even become permanent baldness.
References:
Alopecia areata is not terrible
This disease is often a sudden occurrence of alopecia areata, because most patients don't have any conscious symptoms, they don't know that they have alopecia areata, and they are often told by others when they accidentally find it or get a haircut. Most of these baldness spots are round or oval, with very neat edges. If there are many baldness spots, the boundary is not clear. When it first appeared, the plaque was small, with a diameter of 1-2 cm, which could gradually expand. When alopecia areata develops and expands, the seemingly normal hair around it is easy to be pulled out, and the hair roots are thin, gray and painless. The local scalp is normal in color and the surface is smooth and shiny. Only a few patients are accompanied by local scalp itching and reddish scalp at alopecia areata when they just get sick.
Some patients with alopecia areata have small baldness spots, and the number of baldness spots is only 1-2. They stop expanding within a few weeks, and the hair around them grows firmly, with no symptoms of hair loosening. This is a phenomenon of improvement, and soon the bald spots are smooth.