Bed bugs, known scientifically as Cimex lectularius (Cimicidae) are small wingless insects that feed by hematophagy - exclusively on the blood of warm blooded-animals. As we are warm-blooded animals we are ideal hosts for them. Over millions of years bed bugs have evolved as nest parasites - inhabiting the nests of birds and the roosts of bats. Some of them have learnt to adapt to the human environment and live in our nests, i.e. our homes, and more specifically, our beds. Newborns, called hatchlings or nymphs, are tiny, about the size of a poppy seed, while adults grow to about ¼ of an inch long. Their shape is oval and flattened. Both nymphs, eggs and adults are visible to the naked eye.
They are called bed bugs because of their preferred habitat in human homes: sofas, bed mattresses and other soft furnishings.
Bed bugs are seen as a growing problem within all types of dwellings, including private homes, dormitories, cruise ships, army barracks, and shelters.
When seen close up they may have a white, light tan to a deep brown or burnt orange color. Just after molting most of them are plain white. When they have had their feed a dark red or black blob may be observed within their body. They will instinctively seek shelter in dark cracks and crevices when disturbed.
How dangerous are bed bugs to humans?
Most bed bugs feed on their hosts while they are asleep. The host supplies them with blood in a painless way, never knowing it is happening. While feeding they inject a small amount of saliva into the host's skin. The more they feed on one particular host, say a human, over a period of several weeks, the more sensitized that human becomes to their saliva. Until eventually the host develops a mild to intense allergic response.
People who have become sensitive to bed bug bites - their saliva - have lesions similar to mosquito or flea bites. Most humans will think they have been bitten by some insect, such as a mosquito, and never realize who the true culprit was.
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The common bed bug, (Cimex lectularius) has adapted well to human environments. It is generally found in temperate climates. Cimex hemiterus is more common in tropical regions, and has mainly poultry and bats as its host. Leptocimex boueti, found mainly in South America and West Africa feeds chiefly on humans and bats. Haematosiphon inodora, of North America, feeds primarily on poultry.
How do bed bugs feed?
The most active time for a bed bug is about one hour before sunrise - the peak time for feeding. However, they will try to feed at any time of day or night if they are hungry enough, and if the opportunity is there. They prefer nighttime and hate sunlight.
They will reach their host either by crawling straight towards them, or climbing a wall and then across the ceiling until they feel a heat wave - when they jump down onto their host. The bug is attracted to the host by both its warmth and the presence of C02 (carbon dioxide).
It pierces the skin of its host with two hollow tubes. One tube injects saliva which contains anesthetics, so that the host feels nothing, and anticoagulants, so that the blood flows out freely. The other tube sucks the blood in.
Feeding takes about five minutes, after which the bug returns to its hiding place. Bites are not noticeable by the host until at least a few minutes or some hours afterwards. Hosts, for example humans, will be aware of a bite after scratching it. Often bites may not be noticeable for several days.
Bed bugs will feed every five to ten days. They can, however, last for several months without feeding. If there is no food around they can become dormant for over a year. A well fed bed bug has a lifespan of about six to nine months.
How do bed bugs reproduce?
Bed bugs reproduce by traumatic insemination, also known as hypodermic insemination. The males have hypodermic genitalia which pierce the females anywhere on their abomen and ejaculate sperm into the body cavity. The sperm diffuse through the insides and reach the ovaries, resulting in fertilization.
The female bed bug lays approximately 5 eggs in one day and about 500 during her lifetime. Eggs are about 1 mm long and are visible to the naked eye. They have a milky-white tinge.
The eggs take about two weeks to hatch. The nymphs (baby bed bugs) start feeding as soon as they hatch, and pass through five molting stages before reaching maturity. During each molting stage they need to feed once. It takes about five weeks to reach maturity at a room-temperature environment.
Bed bugs can only reproduce when they have reached maturity.
How do bed bugs get into your house?
Bed bugs may get into a new home as stowaways when luggage, furniture and bedding is moved into a new home - especially in the case of second-hand furniture. Perhaps we should be careful when purchasing second hand furniture at knock-down prices - a careful visual inspection should result in detecting them, if any are present.
Even vacant and seemingly clean homes may have bed bugs in them - they can survive for many months without any food. They can also move from apartment to apartment through hollows in walls and holes and tubes that wires and pipes go through.
A bat or bird that flies into a home could introduce bed bugs, and some other bugs as well.
How do I know if I have bed bugs in my house?
The biggest sign of bed bugs is people complaining of bites that occurred while they were asleep. If this happens you should examine the bedrooms for bed bugs and signs of bed bug activity. Look carefully into the creases in the bed linen, and seams and tufts of mattresses and box springs for bugs or eggs. The eggs will look like tiny pale poppy seeds.
Signs of bed bug activity may exist beneath loose areas of wallpaper near beds, in the corner of desks and dressers, in laundry, and in drawers.
Look out for dark brown or reddish fecal spots (bed bug droppings, excrement). If an area is very infested you may sense a coriander-like odor. The excrement is a liquid that looks either light brown or black that can either bead up or be absorbed by the material around it.
Dogs can be trained to sniff out live bed bugs or past infestations. A dog's sense of smell is so acute that it can pick up the scent of a single bed bug.
What happens when I get bitten?
When you are bitten a raised red bump of flat welt (also called a papule or a wheal) will appear, often accompanied by very intense itching. The anesthetic contained in the bed bugs saliva causes an allergic reaction which results in the red bumps. They look very similar to mosquito bites, but last a lot longer. Signs and symptoms of bug bites will only affect the surface of the skin.
Bites can sometimes take up to nine days to become visible. Unlike flea bites, bed bug bites do not usually have a red dot in the center.
Bed bugs, like fleas, tend to bite in rows. There are likely to be two or three bites all in a row. This is probably because the bed bug is disturbed while feeding, and then comes back about half an inch further down for its next bite; or perhaps it had been trying to find a good vein, and needed several attempts.
About 50% of people who are bitten show no symptoms at all and do not know it happened. This makes it more difficult to prevent or identify potential infestations. Some individuals, however, may become ill and nauseous. It is possible get skin infections and scars from scratching the bites.
When people know they have an infestation of bed bugs in their house they tend to become alarmed. Research, however, indicates that bed bugs do not transmit disease, even though they do bite and take blood. Infections will occur as a result of scratching, and not from a pathogen passed on from the bug.
Very rarely, some people may have an anaphylactic reaction to bed bug bites. It is possible to have an asthmatic reaction when they shed skin as they grow and die; but cases are very rare.
Treatment of bed bug bites
Most bites resolve within one to two weeks. Treatment focuses on relieving symptoms, and include:
* Applying a topical cream, such as cortisone to relieve itching.
* Avoid scratching as this can cause infection.
* If infection does occur an oral antibiotic may be prescribed.
* If there is a severe allergic reaction oral corticosteroids may be prescribed.
* Antihistamines may also help relieve allergic reactions.
As soon as the symptoms are treated it will be necessary deal with the infestation (see below Controlling infestations of bed bugs)
Do bed bugs transmit disease?
Although they look very much like the kind of insect that would transmit disease, like mosquitoes, there are no records anywhere of disease transmission cause by bed bugs - even from sick host to healthy host.
A study carried out by scientists at the Department of Medicine, University of Mississippi Medical Center, Jackson, USA, that reviewed the available evidence on bed bugs found that while they are highly resistant to various ways of getting rid of them, they seem to be more of a nuisance than a serious health problem, but the possibility that they could one day serve as a vehicle for disease has not been well researched.
Scientists say there may be as many as 40 pathogens that could potentially live inside a bed bug or around its mouth area. However, tests have concluded that bed bugs are highly unlikely to carry disease from host to host.
Researchers have concluded that they are much less hazardous to human health than fleas, or other common insects. Nevertheless, these are well formulated opinions, rather than the results of conclusive studies. Some say hepatitis B or Chagas disease could not be discarded as possibilities if the setting were right.
As mentioned before, the biggest risk for humans comes from secondary bacterial infection, which in this case would be as a result of scratching the skin. Scratching, if it breaks the skin, allows bacteria to penetrate - but the bacteria would not have been from the bed bug.
Although they are not known to carry diseases, bed bugs can affect the quality of life of a person who has been bitten, causing distress, discomfort, embarrassment and unsettled sleep.
Controlling infestations of bed bugs
Since they can hide in so many places, they are not easy to eradicate. Unless you have a lot of time at your disposal, and limitless patience, it is advisable to get a professional in pest control. Experts know where to look for them, as well as how to get rid of them.
You can help the pest control professional by removing excess clutter form your house. If your stuff is strewn about rooms the bed bugs will have many extra places to hide, making inspection and eradication that much more difficult.
Some pest control companies may ask you to move furniture away from walls and mattresses and box springs stood on edge before they come in, while others prefer everything to be left where it is so that they can check before moving them themselves.
If you live in an apartment or a house that adjoins another one, it may be necessary to inspect adjoining dwellings to. Bed bugs can easily disperse throughout a building.
The following procedures are advised:
* Bedding and garments which are prone to infestation need to be bagged and laundered at 120 F minimum, because these items cannot be treated with insecticides. Or….
* Place these items in the clothes drier. Set it to high heat for ten to twenty minutes. "Dry-clean only" clothes may be placed in the drier as long as they are completely dry beforehand and are set at moderate heat (less than 160 F). It is possible to send your stuff off to be dry-cleaned - this will kill the bugs; but you may be passing your problem onto the dry-cleaning establishment. When the dry-cleaners open your bags and sort them the little bugs may get away and infest their new home.
* For things that cannot be treated by washing or placing in the drier, wrap them in plastic and place them outdoors in a very hot and sunny location for at least 24 hours. For best results pack each bag loosely. The aim is for an internal temperature of at least 120 F.
* Freezing may also work, but may take several days. It may be an option during winter months when finding hot and sunny locations may not be possible.
* Do not try to kill them off by ramping up the heating in your house - it won't work. Some pest control companies have special heaters for this.
* Although thorough vacuuming may not catch every single bug and egg, it will help get rid of some of the infestation before treatment with insecticides. When vacuuming make sure you include cracks and crevices. Dislodging eggs is extremely difficult - scraping as you vacuum along infested areas, such as fabric folds of beds and sofas and the perimeter edge of wall-to-wall carpets, is more effective. When you have finished make sure you place the vacuum cleaner contents in a sealed bag.
* You may find it is best to throw some infested items away. A pest control professional will help advise you. Make sure you bag these items carefully before moving them.
* Insecticides are a crucial part of getting rid of bed bugs. Do not use baits for ants and cockroaches, they will not work with bed bugs. A good pest control professional will treat all areas where bugs are found, as well as areas bugs tend to like. Depending on the size of your home and the severity of the infestation, this may take several hours. Follow-up visits may also be necessary.
* If you have recently got rid of bats or birds in and around your home it is possible that the bed bugs that fed on them may have switched to human hosts. Bat and bird nesting sites must be treated too.
Scientists at Ohio State University have determined that combining bed bugs' own chemical signals with a common insect control agent makes that treatment more effective at killing the bugs.
Encasing your bed
You could encase both the mattress and box spring in a proactive cover, as some people do for allergy relief. Some pest control firms sell them, as do a number of retail outlets.
As soon as you have encased it and zipped it shut, any bug trapped inside will eventually die - as long as you do not unzip it. Some people keep their new beds encased as it prevents the bugs from getting into the mattress and crevices and makes it easier to keep the surface clean and bug free. It is important to remember that encasements do not stop bugs from crawling onto them. Thank you for reading :)
Wednesday, July 22, 2009
Monday, July 20, 2009
What Is Hair Loss (Alopecia)? What Is Baldness?
The word alopecia refers to any type of hair loss, thinning hair or baldness in any hairy region of the body. Baldness tends to be a more specific term among lay people, as it usually refers to hair loss on the scalp - however, it can mean hair loss in any part of the body. Alopecia areata means "hair loss in areas". In the majority of cases hair loss is a normal process of aging, and not a disease. Because it is not seen as life-threatening to doctors it is often disregarded. This is unfortunate because hair loss can cause serious distress in some people, with some far reaching psychological effects. In some cases hair loss may be a consequence of some medical treatment, especially cancer treatment drugs - when the hair loss is generally temporary.
There are several types of alopecia, below is a list of the main types:
Alopecia areata - hair loss occurring in patches anywhere on the body. Hair is lost from some or all areas of the body, generally from the scalp. As it causes bald spots on the scalp, especially during its early phase, it is sometimes referred to as "spot baldness". A small proportion of alopecia areata cases spread to the whole scalp, or even the entire body. Approximately 0.1% to 0.2% of all humans are affected. It occurs in both men and women, but more commonly among women.
Most people who develop alopecia areata are apparently healthy and have no skin problems. When it does occur, it tends to start during the late teenage years, early childhood, or early adulthood. However, it can strike at any age.
Alopecia areata is not contagious. It is more commonly found among people who have close family member who have/had it. People who have a close relative with some kind of autoimmune disease are more likely to develop alopecia areata. That is why most experts believe it is an autoimmune disease - a disease where the body attacks good parts of the body as if they were foreign undesirable objects, such as some bacteria or viruses; in this case the body is attacking its own hair follicles. Studies indicate that T cell lymphocytes cluster around attacked follicles, causing inflammation and hair loss. Scientists say something, combined with hereditary factors, trigger the condition - we do not know what that something is, although some suspect it may be emotional stress or a pathogen. A pathogen is a disease-producing agent, e.g. a virus, bacterium or other microorganism. A study found that there is a close relationship between infection outbreaks on teeth and the presence of alopecia areata.
Symptoms usually appear as small, soft, bald patches. They may be of various shapes, but are generally round or oval. The scalp and beard are the most commonly affected areas; but can occur in any hairy part of the body. The patient may feel tingling, or even some slight pain in affected areas. Some parts of the body may experience hair re-growth while others will not. It can go into remission for long or short periods, and even forever (gets better and never comes back).
When the hair falls out on the scalp it tends to do so over a short period, and more so on one side than the other.
People with this type of alopecia also have "exclamation point hairs" - hairs that become narrower along the length of the strand closer to the base.
Alopecia totalis - total hair loss of the scalp. This could happen rapidly, or from progression of alopecia areata. Experts are not sure what causes it, but know that it is an autoimmune disorder. Although many believe mental stress is a contributory factor, a sizeable number of people with alopecia totalis lead relatively stress-free lives.
This type of alopecia may be an intermediary condition between Alopecia areata and Alopecia Universalis (total body hair loss). It usually emerges as a fairly sudden total scalp hair loss, or more gradual. When it is gradual it tends to be a development from alopecia areata.
The majority of sufferers are either children or young adults under 40. However alopecia totalis can affect people of any age. The patient's nails may also become ridged, pitted or brittle in appearance.
Alopecia universalis - all hair is lost throughout the body. It generally involves rapid loss of hair, including eyebrows and eyelashes. Experts consider it to be the most severe form of alopecia areata. It affects approximately 1 in every 100,000 people in North America and Western Europe. It is an autoimmune condition.
Alopecia barbae - loss of facial hear. Barbae comes from Latin and refers to the bearded area of the face. It does, in fact, affect both men and women. However, it is of more interest to men as only men are generally bothered by it.
Alopecia mucinosa - also referred to as follicular mucinosis. It is an inflammatory condition of both the hair follicle and sebaceous glands (pilosebaceous unit) which can result in scarring as well as non-scarring hair loss. Severity of scarring indicates how advanced the disease is. There is mucin around hair follicles when examined under the microscope. Mucins appear like stringy, clear or whitish gunk in the skin, and are made up mostly of hyaluronic acid - this is a normal component of the ground substance surrounding collagen of the dermis (part of the skin).
Alopecia mucinosa generally affects the face, neck, and scalp, but can affect any part of the body.
Alopecia mucinosa can be one of three types: 1. Primary and acute disorder - this affects children and teenagers (Pinkus type). 2. Primary and chronic disorder - this occurs in people over 40. 3. Secondary disorder - this is associated with benign (non-cancerous) or malignant (cancerous) skin disease.
Experts are not sure why it occurs, but it is seen as an autoimmune disease. Early signs include raised spots (follicular papules) which appear in reddened plaques or patches, about 2.5 centimeters in diameter, but they can be bigger. Some patients may start with one or more lesions, while others may have a single lesion that develops to multiple lesions over several weeks or months. The affected follicles will commonly result in hair loss.
If treated early enough it is reversible - hair will grow back. In more severe cases hair will not grow back, even after the disease has cleared up.
Androgenetic alopecia (male pattern hair loss) - this is also known as male pattern baldness. The hair gradually thins out, to an almost transparent state. It can affect both men and women. Experts say this type of alopecia is most likely to be hereditary - the person can inherit from either the mother or the father. Androgens means hormones. This type of alopecia is the type most lay people refer to when talking about balding.
Male pattern baldness usually starts with a receding hairline, and/or hair loss on the top of the head.
The person has a genetically determined sensitivity to the effects of DHT (dihydrotestosterone). Experts believe DHT shortens the growth phase (anagen phase) of the hair cycle, causing miniaturization of the follicles, resulting in finer hair. DHT production is regulated by 5-alpha reductase, an enzyme. DHT exists in several tissues of the body, including the scalp.
About 50% of men are affected by this type of hair loss at some time in their lives. Men of Chinese or Japanese ancestry are less likely to be affected.
A Chinese study found that men who smoked were more prone to age-related hair loss.
A study identified two genetic variants in Caucasians that together produce an astounding sevenfold increase in the risk of male pattern baldness.
Adrogenetic alopecia (female pattern hair loss) - this is also known as female pattern baldness. Women have a higher risk of female pattern baldness when they undergo hormonal changes during the menopause. The hair on the head is thinner, while facial hair may be coarser. Although new hair is not produced, the follicles are still alive. This suggests that hair regrowth is possible.
Generally, female pattern baldness is different from male pattern baldness. The woman will experience hair thinning all over the head, but will not usually lose her frontal hairline (it will not recede). Loss of hair on the crown may be moderate, but his hardly ever progresses to total or near baldness. Women can lose hair for other reasons than female pattern baldness:
* Teologen effluvium (temporary shedding of hair)
* The hair may breaks after styling treatments, or the twisting and pulling of hair
* Alopecia areata
* Some skin diseases
* Iron deficiency
* Hormonal problems
* Underactive thyroid
* Vitamin deficiency
Traction alopecia - this refers to hair loss as a result of too much pulling or tension on the hair shafts - usually the result of some hair styles. This type of alopecia is more commonly found among women. If the traction alopecia is prolonged the person's hair, where lost, may never come back.
Very tight ponytails, braids, or pigtails may cause traction alopecia if the person frequently uses them. Toy dogs whose owners use barrettes to keep hair out of their faces may also develop this type of alopecia.
Anagen effluvium - generally brought on by the use of chemotherapy or radiotherapy to treat cancer. Hair loss starts off as patchy, and then becomes total. Fortunately, in the vast majority of cases, as soon as the treatment is stopped the hair comes back within about six or so months. Some other medications can also cause hair loss. Compulsive hair pulling can also cause this type of hair loss, as well as poisoning from toxic plants, and some other diseases.
Anagen effluvium is caused by sudden, profound disturbances to the matrix cells of the hair follicles.
Telogen effluvium - more than normal amounts of hair fall out. It is characterized by excessive and early entry of hairs into the telogen phase (resting phase). This is a temporary condition - the hair comes back. It is thought to be caused by marked emotional or physiological stressful events that may result in an alteration of the normal hair cycle. The events may include childbirth, chronic illness, major surgery, anemia, crash diets, severe emotional disorders, or drugs.
What are the treatments for alopecia?
If the hair loss is caused by an infection or a condition, treating that infection/condition may prevent further hair loss, and in many cases re-growth will occur.
Male-pattern baldness treatment
* Finasteride - this works by preventing the hormone testosterone converting to the hormone DHT (dihydrotestosterone) which causes hair follicles to shrink. Finasteride effectively brings back normal hair size (from being very fine hair). According the National Health Service, UK, two-thirds of males who are given finasteride experience some hair regrowth. However, even among the other third who experience no regrowth, most stop becoming balder. The effects of finasteride are not evident for at least four months. If the patient stops taking finasteride the balding process will resume. About 1 in every 50 men who take finasteride experiences a loss of libido (sex drive).
* Minoxidil - this is available as a lotion. The person rubs it into the scalp on a daily basis. In the UK, and most other countries it is available over-the-counter (no prescription needed). About 15% of men who use it experience hair regrowth, while half of all men notice that the balding process stops. For about 32% of all men, minoxidil has no effect at all. It is only after four months of daily applications that those who do benefit from minoxidil notice it. If treatment is stopped the balding process will resume. Side effects are uncommon.
* Laser phototherapy - a controlled clinical trial proved the clinical efficacy and safety of a laser phototherapy device for treating hereditary hair loss, according to an article.
* Dermabrasion gel - scientists have found a way to make the skin of laboratory mice give have fully working hair follicles complete with new hair by using a protein that stimulates follicle generating genes in skin cells under wound conditions.
Female-pattern baldness treatment
The only effective medication for women with female-pattern baldness is minoxidil. About 20% to 25% of UK women who take it experience hair regrowth, while the majority finds the treatment stops or slows the loss of hair. Other treatments include hair transplants, wigs, hair weaving, changes in hairstyle, plastic surgery (scalp reduction).
Alopecia areata treatment
There is no current reliable, safe, effective, long term treatment for alopecia areata, a study showed. Fortunately, about 80% of cases resolve themselves after a year without treatment and hair grows back. Therefore, watchful waiting may be the best initial strategy. If it does not resolve itself, some treatments are possible:
* Steroid injections - effective when the patient has small patches. A steroid solution is injected straight into the scalp, several times. The steroid stops the immune system from attacking hair follicles. After about four weeks this treatment may stimulate regrowth. Treatment might be repeated every few months. With some patients alopecia returns some time after treatment is stopped, while with others the regrowth is permanent.
* Topical steroids (creams and ointments) and steroid tablets - although these medications are widely prescribed for alopecia areata treatment, their long-term benefits are not clear. It seems there is a chance hair will regrow. Side effects become more common the longer the patient takes the steroid tablets or creams/ointments; they may include diabetes and stomach ulcers. Some patients experience itching, and sometimes hair growth in other areas.
* Minoxidil - applied in lotion form to the scalp every day, this treatment can stimulate hair growth. Benefits, if they do appear, do so after about two or three months. In the UK they are not recommended for people under the age of 16.
* Immunotherapy - this is the most effective treatment for total hair loss. DPCP (diphencyprone) is applied to the bald skin. The patient applies the chemical solution once a week, and the dosage is stronger each time. The DPCP generally causes an allergic reaction and the patient will develop mild dermatitis (mild eczema). Hair starts to regrow after about three months among patients who respond. Some patients may have a severe skin reaction. This can be dealt with by reducing the rate of dosage increase. A very small percentage of patients may develop vitiligo (patchy colored skin). Most patients find that hair continues falling out after treatment is stopped.
* Dithranol cream - this treatment is much less popular than immunotherapy because it is less effective and there is a greater risk of causing a skin reaction and itchiness. It can also stain the scalp and hair.
* UV light treatment - the patient is given about two to three sessions of light therapy each week. This is usually done in a hospital. After about 12 months patients may see some good results. It is not very popular as response rates are not so good.
* Tattooing the eyebrows - this is known as dermatography.
* Alternative therapies - alternative therapists commonly offer aromatherapy, massage, or acupuncture for alopecia treatment. Not enough studies exist to determine how effective these treatments are. Thank you for reading :)
There are several types of alopecia, below is a list of the main types:
Alopecia areata - hair loss occurring in patches anywhere on the body. Hair is lost from some or all areas of the body, generally from the scalp. As it causes bald spots on the scalp, especially during its early phase, it is sometimes referred to as "spot baldness". A small proportion of alopecia areata cases spread to the whole scalp, or even the entire body. Approximately 0.1% to 0.2% of all humans are affected. It occurs in both men and women, but more commonly among women.
Most people who develop alopecia areata are apparently healthy and have no skin problems. When it does occur, it tends to start during the late teenage years, early childhood, or early adulthood. However, it can strike at any age.
Alopecia areata is not contagious. It is more commonly found among people who have close family member who have/had it. People who have a close relative with some kind of autoimmune disease are more likely to develop alopecia areata. That is why most experts believe it is an autoimmune disease - a disease where the body attacks good parts of the body as if they were foreign undesirable objects, such as some bacteria or viruses; in this case the body is attacking its own hair follicles. Studies indicate that T cell lymphocytes cluster around attacked follicles, causing inflammation and hair loss. Scientists say something, combined with hereditary factors, trigger the condition - we do not know what that something is, although some suspect it may be emotional stress or a pathogen. A pathogen is a disease-producing agent, e.g. a virus, bacterium or other microorganism. A study found that there is a close relationship between infection outbreaks on teeth and the presence of alopecia areata.
Symptoms usually appear as small, soft, bald patches. They may be of various shapes, but are generally round or oval. The scalp and beard are the most commonly affected areas; but can occur in any hairy part of the body. The patient may feel tingling, or even some slight pain in affected areas. Some parts of the body may experience hair re-growth while others will not. It can go into remission for long or short periods, and even forever (gets better and never comes back).
When the hair falls out on the scalp it tends to do so over a short period, and more so on one side than the other.
People with this type of alopecia also have "exclamation point hairs" - hairs that become narrower along the length of the strand closer to the base.
Alopecia totalis - total hair loss of the scalp. This could happen rapidly, or from progression of alopecia areata. Experts are not sure what causes it, but know that it is an autoimmune disorder. Although many believe mental stress is a contributory factor, a sizeable number of people with alopecia totalis lead relatively stress-free lives.
This type of alopecia may be an intermediary condition between Alopecia areata and Alopecia Universalis (total body hair loss). It usually emerges as a fairly sudden total scalp hair loss, or more gradual. When it is gradual it tends to be a development from alopecia areata.
The majority of sufferers are either children or young adults under 40. However alopecia totalis can affect people of any age. The patient's nails may also become ridged, pitted or brittle in appearance.
Alopecia universalis - all hair is lost throughout the body. It generally involves rapid loss of hair, including eyebrows and eyelashes. Experts consider it to be the most severe form of alopecia areata. It affects approximately 1 in every 100,000 people in North America and Western Europe. It is an autoimmune condition.
Alopecia barbae - loss of facial hear. Barbae comes from Latin and refers to the bearded area of the face. It does, in fact, affect both men and women. However, it is of more interest to men as only men are generally bothered by it.
Alopecia mucinosa - also referred to as follicular mucinosis. It is an inflammatory condition of both the hair follicle and sebaceous glands (pilosebaceous unit) which can result in scarring as well as non-scarring hair loss. Severity of scarring indicates how advanced the disease is. There is mucin around hair follicles when examined under the microscope. Mucins appear like stringy, clear or whitish gunk in the skin, and are made up mostly of hyaluronic acid - this is a normal component of the ground substance surrounding collagen of the dermis (part of the skin).
Alopecia mucinosa generally affects the face, neck, and scalp, but can affect any part of the body.
Alopecia mucinosa can be one of three types: 1. Primary and acute disorder - this affects children and teenagers (Pinkus type). 2. Primary and chronic disorder - this occurs in people over 40. 3. Secondary disorder - this is associated with benign (non-cancerous) or malignant (cancerous) skin disease.
Experts are not sure why it occurs, but it is seen as an autoimmune disease. Early signs include raised spots (follicular papules) which appear in reddened plaques or patches, about 2.5 centimeters in diameter, but they can be bigger. Some patients may start with one or more lesions, while others may have a single lesion that develops to multiple lesions over several weeks or months. The affected follicles will commonly result in hair loss.
If treated early enough it is reversible - hair will grow back. In more severe cases hair will not grow back, even after the disease has cleared up.
Androgenetic alopecia (male pattern hair loss) - this is also known as male pattern baldness. The hair gradually thins out, to an almost transparent state. It can affect both men and women. Experts say this type of alopecia is most likely to be hereditary - the person can inherit from either the mother or the father. Androgens means hormones. This type of alopecia is the type most lay people refer to when talking about balding.
Male pattern baldness usually starts with a receding hairline, and/or hair loss on the top of the head.
The person has a genetically determined sensitivity to the effects of DHT (dihydrotestosterone). Experts believe DHT shortens the growth phase (anagen phase) of the hair cycle, causing miniaturization of the follicles, resulting in finer hair. DHT production is regulated by 5-alpha reductase, an enzyme. DHT exists in several tissues of the body, including the scalp.
About 50% of men are affected by this type of hair loss at some time in their lives. Men of Chinese or Japanese ancestry are less likely to be affected.
A Chinese study found that men who smoked were more prone to age-related hair loss.
A study identified two genetic variants in Caucasians that together produce an astounding sevenfold increase in the risk of male pattern baldness.
Adrogenetic alopecia (female pattern hair loss) - this is also known as female pattern baldness. Women have a higher risk of female pattern baldness when they undergo hormonal changes during the menopause. The hair on the head is thinner, while facial hair may be coarser. Although new hair is not produced, the follicles are still alive. This suggests that hair regrowth is possible.
Generally, female pattern baldness is different from male pattern baldness. The woman will experience hair thinning all over the head, but will not usually lose her frontal hairline (it will not recede). Loss of hair on the crown may be moderate, but his hardly ever progresses to total or near baldness. Women can lose hair for other reasons than female pattern baldness:
* Teologen effluvium (temporary shedding of hair)
* The hair may breaks after styling treatments, or the twisting and pulling of hair
* Alopecia areata
* Some skin diseases
* Iron deficiency
* Hormonal problems
* Underactive thyroid
* Vitamin deficiency
Traction alopecia - this refers to hair loss as a result of too much pulling or tension on the hair shafts - usually the result of some hair styles. This type of alopecia is more commonly found among women. If the traction alopecia is prolonged the person's hair, where lost, may never come back.
Very tight ponytails, braids, or pigtails may cause traction alopecia if the person frequently uses them. Toy dogs whose owners use barrettes to keep hair out of their faces may also develop this type of alopecia.
Anagen effluvium - generally brought on by the use of chemotherapy or radiotherapy to treat cancer. Hair loss starts off as patchy, and then becomes total. Fortunately, in the vast majority of cases, as soon as the treatment is stopped the hair comes back within about six or so months. Some other medications can also cause hair loss. Compulsive hair pulling can also cause this type of hair loss, as well as poisoning from toxic plants, and some other diseases.
Anagen effluvium is caused by sudden, profound disturbances to the matrix cells of the hair follicles.
Telogen effluvium - more than normal amounts of hair fall out. It is characterized by excessive and early entry of hairs into the telogen phase (resting phase). This is a temporary condition - the hair comes back. It is thought to be caused by marked emotional or physiological stressful events that may result in an alteration of the normal hair cycle. The events may include childbirth, chronic illness, major surgery, anemia, crash diets, severe emotional disorders, or drugs.
What are the treatments for alopecia?
If the hair loss is caused by an infection or a condition, treating that infection/condition may prevent further hair loss, and in many cases re-growth will occur.
Male-pattern baldness treatment
* Finasteride - this works by preventing the hormone testosterone converting to the hormone DHT (dihydrotestosterone) which causes hair follicles to shrink. Finasteride effectively brings back normal hair size (from being very fine hair). According the National Health Service, UK, two-thirds of males who are given finasteride experience some hair regrowth. However, even among the other third who experience no regrowth, most stop becoming balder. The effects of finasteride are not evident for at least four months. If the patient stops taking finasteride the balding process will resume. About 1 in every 50 men who take finasteride experiences a loss of libido (sex drive).
* Minoxidil - this is available as a lotion. The person rubs it into the scalp on a daily basis. In the UK, and most other countries it is available over-the-counter (no prescription needed). About 15% of men who use it experience hair regrowth, while half of all men notice that the balding process stops. For about 32% of all men, minoxidil has no effect at all. It is only after four months of daily applications that those who do benefit from minoxidil notice it. If treatment is stopped the balding process will resume. Side effects are uncommon.
* Laser phototherapy - a controlled clinical trial proved the clinical efficacy and safety of a laser phototherapy device for treating hereditary hair loss, according to an article.
* Dermabrasion gel - scientists have found a way to make the skin of laboratory mice give have fully working hair follicles complete with new hair by using a protein that stimulates follicle generating genes in skin cells under wound conditions.
Female-pattern baldness treatment
The only effective medication for women with female-pattern baldness is minoxidil. About 20% to 25% of UK women who take it experience hair regrowth, while the majority finds the treatment stops or slows the loss of hair. Other treatments include hair transplants, wigs, hair weaving, changes in hairstyle, plastic surgery (scalp reduction).
Alopecia areata treatment
There is no current reliable, safe, effective, long term treatment for alopecia areata, a study showed. Fortunately, about 80% of cases resolve themselves after a year without treatment and hair grows back. Therefore, watchful waiting may be the best initial strategy. If it does not resolve itself, some treatments are possible:
* Steroid injections - effective when the patient has small patches. A steroid solution is injected straight into the scalp, several times. The steroid stops the immune system from attacking hair follicles. After about four weeks this treatment may stimulate regrowth. Treatment might be repeated every few months. With some patients alopecia returns some time after treatment is stopped, while with others the regrowth is permanent.
* Topical steroids (creams and ointments) and steroid tablets - although these medications are widely prescribed for alopecia areata treatment, their long-term benefits are not clear. It seems there is a chance hair will regrow. Side effects become more common the longer the patient takes the steroid tablets or creams/ointments; they may include diabetes and stomach ulcers. Some patients experience itching, and sometimes hair growth in other areas.
* Minoxidil - applied in lotion form to the scalp every day, this treatment can stimulate hair growth. Benefits, if they do appear, do so after about two or three months. In the UK they are not recommended for people under the age of 16.
* Immunotherapy - this is the most effective treatment for total hair loss. DPCP (diphencyprone) is applied to the bald skin. The patient applies the chemical solution once a week, and the dosage is stronger each time. The DPCP generally causes an allergic reaction and the patient will develop mild dermatitis (mild eczema). Hair starts to regrow after about three months among patients who respond. Some patients may have a severe skin reaction. This can be dealt with by reducing the rate of dosage increase. A very small percentage of patients may develop vitiligo (patchy colored skin). Most patients find that hair continues falling out after treatment is stopped.
* Dithranol cream - this treatment is much less popular than immunotherapy because it is less effective and there is a greater risk of causing a skin reaction and itchiness. It can also stain the scalp and hair.
* UV light treatment - the patient is given about two to three sessions of light therapy each week. This is usually done in a hospital. After about 12 months patients may see some good results. It is not very popular as response rates are not so good.
* Tattooing the eyebrows - this is known as dermatography.
* Alternative therapies - alternative therapists commonly offer aromatherapy, massage, or acupuncture for alopecia treatment. Not enough studies exist to determine how effective these treatments are. Thank you for reading :)
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